Provider Demographics
NPI:1790387454
Name:KINSER, RACHEL NICOLE
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:NICOLE
Last Name:KINSER
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 1:177 CRUM RD
Mailing Address - Street 2:
Mailing Address - City:CRUM
Mailing Address - State:WV
Mailing Address - Zip Code:25669-9606
Mailing Address - Country:US
Mailing Address - Phone:681-735-3280
Mailing Address - Fax:
Practice Address - Street 1:177 CRUM RD
Practice Address - Street 2:
Practice Address - City:CRUM
Practice Address - State:WV
Practice Address - Zip Code:25669-9606
Practice Address - Country:US
Practice Address - Phone:681-735-3280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant