Provider Demographics
NPI:1881192441
Name:CALLAWAY, KINSEY (ARNP)
Entity Type:Individual
Prefix:
First Name:KINSEY
Middle Name:
Last Name:CALLAWAY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KINSEY
Other - Middle Name:
Other - Last Name:ROSEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2414 E PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5301
Mailing Address - Country:US
Mailing Address - Phone:850-702-9940
Mailing Address - Fax:850-702-9941
Practice Address - Street 1:2414 E PLAZA DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5301
Practice Address - Country:US
Practice Address - Phone:850-702-9940
Practice Address - Fax:850-702-9941
Is Sole Proprietor?:No
Enumeration Date:2018-01-30
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9447761363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner