Provider Demographics
NPI:1922560309
Name:KINSINGER, KRISTEN NOEL (LPN)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:NOEL
Last Name:KINSINGER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 38TH ST NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44709-2443
Mailing Address - Country:US
Mailing Address - Phone:330-312-1534
Mailing Address - Fax:
Practice Address - Street 1:4315 FULTON DR NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2823
Practice Address - Country:US
Practice Address - Phone:330-312-1534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-03
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN145470164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse