Provider Demographics
NPI:1518698349
Name:KINSEY, KIRSTEN L (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:L
Last Name:KINSEY
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25350 ROCKSIDE RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44146-7110
Mailing Address - Country:US
Mailing Address - Phone:216-961-8804
Mailing Address - Fax:440-374-4965
Practice Address - Street 1:2663 CLEVELAND AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44709-3393
Practice Address - Country:US
Practice Address - Phone:330-456-7191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0031483363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health