Provider Demographics
NPI:1407397086
Name:KINCADE, MOSHE JONIQUE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:MOSHE
Middle Name:JONIQUE
Last Name:KINCADE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2835 SW MISSION WOODS DR
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614
Mailing Address - Country:US
Mailing Address - Phone:785-271-1818
Mailing Address - Fax:785-271-7522
Practice Address - Street 1:2835 SW MISSION WOODS DR
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-5616
Practice Address - Country:US
Practice Address - Phone:785-271-1818
Practice Address - Fax:785-271-7522
Is Sole Proprietor?:No
Enumeration Date:2017-03-15
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-77504-072363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily