Provider Demographics
NPI:1689936080
Name:KINSEY, JOAN (MSM , APRN)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:KINSEY
Suffix:
Gender:F
Credentials:MSM , APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 POLLY DRUMMOND SHPG CTR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-4861
Mailing Address - Country:US
Mailing Address - Phone:800-838-9800
Mailing Address - Fax:
Practice Address - Street 1:16 POLLY DRUMMOND SHPG CTR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-4861
Practice Address - Country:US
Practice Address - Phone:800-839-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELP 0000159363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD317290OtherKAISER
MD8525910OtherAETNA HMO
MD9844956OtherAETNA PPO
MD246223Y5ZMedicare PIN