Provider Demographics
NPI:1821345083
Name:KINSEY, ALICIA LAUREN (PT)
Entity Type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:LAUREN
Last Name:KINSEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1317 N BRIGHTLEAF BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-7267
Mailing Address - Country:US
Mailing Address - Phone:919-300-5040
Mailing Address - Fax:919-438-0893
Practice Address - Street 1:1317 N BRIGHTLEAF BLVD STE A
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-7267
Practice Address - Country:US
Practice Address - Phone:919-300-5040
Practice Address - Fax:919-438-0893
Is Sole Proprietor?:No
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP13858225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist