Provider Demographics
NPI:1922316124
Name:KINNEY, WENDY JEAN (AA)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:JEAN
Last Name:KINNEY
Suffix:
Gender:F
Credentials:AA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:300 JEFFORDS ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3810
Mailing Address - Country:US
Mailing Address - Phone:727-441-1524
Mailing Address - Fax:727-443-4206
Practice Address - Street 1:300 JEFFORDS ST
Practice Address - Street 2:SUITE B
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3810
Practice Address - Country:US
Practice Address - Phone:727-441-1524
Practice Address - Fax:727-443-4206
Is Sole Proprietor?:No
Enumeration Date:2010-09-22
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAA61174400000X, 367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant
No174400000XOther Service ProvidersSpecialist