Provider Demographics
NPI:1376258186
Name:KINSINGER, MIRANDA MAY (MSN, APRN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MIRANDA
Middle Name:MAY
Last Name:KINSINGER
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:MS
Other - First Name:KENDRA
Other - Middle Name:MIRANDA
Other - Last Name:RASMUSSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:519 FRANKLIN ST STE 203
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:IL
Mailing Address - Zip Code:60450-1881
Mailing Address - Country:US
Mailing Address - Phone:815-942-1256
Mailing Address - Fax:815-942-5203
Practice Address - Street 1:519 FRANKLIN ST STE 203
Practice Address - Street 2:
Practice Address - City:MORRIS
Practice Address - State:IL
Practice Address - Zip Code:60450-1881
Practice Address - Country:US
Practice Address - Phone:815-942-1256
Practice Address - Fax:815-942-5203
Is Sole Proprietor?:No
Enumeration Date:2023-01-16
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.449582163W00000X
IL209.026772363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse