Provider Demographics
NPI:1659152593
Name:KINSER, HANNAH R (FNP)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:R
Last Name:KINSER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:R
Other - Last Name:RODAWALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 419052
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-9052
Mailing Address - Country:US
Mailing Address - Phone:314-851-1000
Mailing Address - Fax:
Practice Address - Street 1:13303 TESSON FERRY RD STE 150
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-4066
Practice Address - Country:US
Practice Address - Phone:314-842-4744
Practice Address - Fax:314-842-3835
Is Sole Proprietor?:No
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023039041363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily