=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699659912
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DOLLY MARIE KINSEY
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/31/2025
-----------------------------------------------------
Last Update Date | 08/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 348 S BODMER AVE
-----------------------------------------------------
City | STRASBURG
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44680-1159
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-987-5086
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 169 NEIGHBOR ST
-----------------------------------------------------
City | NEWCOMERSTOWN
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43832-1046
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-407-3330
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3747P1801X
-----------------------------------------------------
Taxonomy Name | Personal Care Attendant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------