Provider Demographics
NPI:1891032199
Name:KINSEY, MICHELLE JONES (RN)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:JONES
Last Name:KINSEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:JONES
Other - Last Name:KINSEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:762 DICKINSON ST
Mailing Address - Street 2:
Mailing Address - City:BAMBERG
Mailing Address - State:SC
Mailing Address - Zip Code:29003-1272
Mailing Address - Country:US
Mailing Address - Phone:803-245-3043
Mailing Address - Fax:803-245-3051
Practice Address - Street 1:1980 MAIN HWY
Practice Address - Street 2:
Practice Address - City:BAMBERG
Practice Address - State:SC
Practice Address - Zip Code:29003-8363
Practice Address - Country:US
Practice Address - Phone:803-245-3043
Practice Address - Fax:803-245-3051
Is Sole Proprietor?:No
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCRN.62168163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool