Provider Demographics
NPI:1851675615
Name:KINSEY, JAMIE R (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:R
Last Name:KINSEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5002 CAMPTON CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2048
Mailing Address - Country:US
Mailing Address - Phone:352-572-2913
Mailing Address - Fax:
Practice Address - Street 1:5002 CAMPTON CT
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2048
Practice Address - Country:US
Practice Address - Phone:352-572-2913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFP791YOtherMEDICARE