Provider Demographics
NPI:1053135848
Name:KINSER, CYNTHIA JOLENE (APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:JOLENE
Last Name:KINSER
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2033 JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:EDNA
Mailing Address - State:KS
Mailing Address - Zip Code:67342-9329
Mailing Address - Country:US
Mailing Address - Phone:620-515-5304
Mailing Address - Fax:
Practice Address - Street 1:1601 W 4TH ST
Practice Address - Street 2:
Practice Address - City:COFFEYVILLE
Practice Address - State:KS
Practice Address - Zip Code:67337-3333
Practice Address - Country:US
Practice Address - Phone:620-251-7400
Practice Address - Fax:620-251-7400
Is Sole Proprietor?:No
Enumeration Date:2024-11-08
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-119249-102163W00000X
KS53-83908-102363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse