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General NPI Number Information
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NPI Number | 1831386762
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Entity Type | Individual
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Provider Name | DEANNA C KINSMAN PT
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Gender | Female
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Dates
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Enumeration Date | 09/25/2007
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Last Update Date | 02/09/2010
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Provider Practice Location Address
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Address Line | 290 W GEORGIA AVE
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City | NAMPA
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State | ID
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Zip | 83686-2835
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Country | US
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Telephone | 208-468-5970
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Fax | 208-463-3044
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Provider Business Mailing Address
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Address Line | 217 W GEORGIA AVE SUITE 115
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City | NAMPA
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State | ID
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Zip | 83686-6811
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Country | US
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Telephone | 208-463-3234
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Fax | 208-463-3044
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT2252
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License Number State | ID
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