Healthcare Provider Details

I. General information

NPI: 1891032199
Provider Name (Legal Business Name): MICHELLE JONES KINSEY R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE JONES KINSEY R.N.

II. Dates (important events)

Enumeration Date: 01/08/2013
Last Update Date: 01/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1980 MAIN HWY
BAMBERG SC
29003-8363
US

IV. Provider business mailing address

762 DICKINSON ST
BAMBERG SC
29003-1272
US

V. Phone/Fax

Practice location:
  • Phone: 803-245-3043
  • Fax: 803-245-3051
Mailing address:
  • Phone: 803-245-3043
  • Fax: 803-245-3051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN.62168
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: