Provider Demographics
NPI:1609426584
Name:KINCAID, DENISE MARIE (FNP)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:MARIE
Last Name:KINCAID
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1986 DUBLIN RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:MA
Mailing Address - Zip Code:01254-5069
Mailing Address - Country:US
Mailing Address - Phone:413-212-8615
Mailing Address - Fax:
Practice Address - Street 1:780 MAIN ST
Practice Address - Street 2:
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-2148
Practice Address - Country:US
Practice Address - Phone:413-344-3882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-12
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN270819207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine