Provider Demographics
NPI:1518108158
Name:KINSMAN, AUBREY LYNN (PA)
Entity Type:Individual
Prefix:
First Name:AUBREY
Middle Name:LYNN
Last Name:KINSMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:AUBREY
Other - Middle Name:LYNN
Other - Last Name:CORRIGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:80 SEYMOUR STREET
Mailing Address - Street 2:HARTFORD HOSPITAL SURGERY DEPT
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06102-5037
Mailing Address - Country:US
Mailing Address - Phone:860-972-4670
Mailing Address - Fax:
Practice Address - Street 1:155 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8710
Practice Address - Country:US
Practice Address - Phone:910-715-4111
Practice Address - Fax:910-715-4101
Is Sole Proprietor?:No
Enumeration Date:2009-03-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013164363A00000X
CT002651363A00000X, 363AM0700X, 363AS0400X
NC0010-07463363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical