Provider Demographics
NPI:1245534361
Name:KIND, JENNIFER A
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:A
Last Name:KIND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 E CAMPUS MALL
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53715-1365
Mailing Address - Country:US
Mailing Address - Phone:608-262-0932
Mailing Address - Fax:608-890-2203
Practice Address - Street 1:333 E CAMPUS MALL
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53715-1365
Practice Address - Country:US
Practice Address - Phone:608-262-0932
Practice Address - Fax:608-890-2203
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-04
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI144615-30163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health