Provider Demographics
NPI:1750023016
Name:KINSMAN, CHRISTINE MICHELE (RN)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MICHELE
Last Name:KINSMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W10950 ARBOR VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:WI
Mailing Address - Zip Code:53555-1608
Mailing Address - Country:US
Mailing Address - Phone:608-438-4673
Mailing Address - Fax:
Practice Address - Street 1:W10950 ARBOR VALLEY RD
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:WI
Practice Address - Zip Code:53555-1608
Practice Address - Country:US
Practice Address - Phone:608-438-4673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-08
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI163860163WH0200X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health