Provider Demographics
NPI:1669280459
Name:KINDER, KASSIE NICOLE (APRN)
Entity type:Individual
Prefix:
First Name:KASSIE
Middle Name:NICOLE
Last Name:KINDER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9985 EMMONS RD
Mailing Address - Street 2:
Mailing Address - City:ASHFORD
Mailing Address - State:WV
Mailing Address - Zip Code:25009-9598
Mailing Address - Country:US
Mailing Address - Phone:304-437-0539
Mailing Address - Fax:
Practice Address - Street 1:885 SE 6TH AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5184
Practice Address - Country:US
Practice Address - Phone:561-815-4074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-25
Last Update Date:2024-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11036517363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily