Provider Demographics
NPI:1760912828
Name:KINSLER, SHOSHANNAH SEED (DNP)
Entity Type:Individual
Prefix:
First Name:SHOSHANNAH
Middle Name:SEED
Last Name:KINSLER
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1130
Mailing Address - Street 2:
Mailing Address - City:GIRDWOOD
Mailing Address - State:AK
Mailing Address - Zip Code:99587-1130
Mailing Address - Country:US
Mailing Address - Phone:077-831-3559
Mailing Address - Fax:907-248-0045
Practice Address - Street 1:131 LINDBLAD AVE.
Practice Address - Street 2:
Practice Address - City:GIRDWOOD
Practice Address - State:AK
Practice Address - Zip Code:99587
Practice Address - Country:US
Practice Address - Phone:907-783-1355
Practice Address - Fax:907-783-1357
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK122641363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty