Provider Demographics
NPI:1760683114
Name:KINCAID, JENNIFER E (RN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:E
Last Name:KINCAID
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 1:1 BALSAM WAY
Mailing Address - Street 2:# 206
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-8119
Mailing Address - Country:US
Mailing Address - Phone:603-315-5109
Mailing Address - Fax:
Practice Address - Street 1:401 CYPRESS ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-3628
Practice Address - Country:US
Practice Address - Phone:603-668-4111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH057051-21163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health