MEDICARE: CHRISTOPHER TODD KINNA PMHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	932378	TX
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1140165	TX

General Provider Information

NPI Number	:	1194440578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER TODD KINNA PMHNP

Provider Business Mailing Address
First Line	:	19106 US HIGHWAY 281 N STE 101
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4988
Country	:	US
Telephone Number	:	210-953-0840
Fax Number	:

Provider Business Practice Location Address
First Line	:	20915 WILDERNESS OAK APT 7207
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-2611
Country	:	US
Telephone Number	:	210-643-0261
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2022
Last Update Date	:	07/14/2025

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