Provider Demographics
NPI:1598883035
Name:KINSLEY, TINA RENEE (MD)
Entity Type:Individual
Prefix:DR
First Name:TINA
Middle Name:RENEE
Last Name:KINSLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:16910 FRANCES ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-2398
Mailing Address - Country:US
Mailing Address - Phone:402-505-8777
Mailing Address - Fax:402-933-7767
Practice Address - Street 1:16910 FRANCES ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-2398
Practice Address - Country:US
Practice Address - Phone:402-505-8777
Practice Address - Fax:402-933-7767
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE35753207N00000X
MI4301102115207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1598883035OtherNPI
MI4301102115OtherSTATE LICENSE
NE35753OtherMEDICAL LICENSE