Provider Demographics
NPI:1346439916
Name:KINLOW, ANTOINETTE N/A (RN)
Entity Type:Individual
Prefix:MS
First Name:ANTOINETTE
Middle Name:N/A
Last Name:KINLOW
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5110 N 84TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53225-4207
Mailing Address - Country:US
Mailing Address - Phone:414-461-5171
Mailing Address - Fax:414-461-5171
Practice Address - Street 1:5110 N. 84TH STREET
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53225-4207
Practice Address - Country:US
Practice Address - Phone:414-461-5171
Practice Address - Fax:414-461-5171
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-19
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39942200Medicaid