Provider Demographics
NPI:1659611515
Name:KINSELLA, ANNMARIE
Entity Type:Individual
Prefix:
First Name:ANNMARIE
Middle Name:
Last Name:KINSELLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 W ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:CRESTON
Mailing Address - State:IA
Mailing Address - Zip Code:50801-3108
Mailing Address - Country:US
Mailing Address - Phone:641-782-2494
Mailing Address - Fax:
Practice Address - Street 1:319 W ADAMS ST
Practice Address - Street 2:
Practice Address - City:CRESTON
Practice Address - State:IA
Practice Address - Zip Code:50801-3108
Practice Address - Country:US
Practice Address - Phone:641-782-2494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-28
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00742237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist