Provider Demographics
NPI:1881442416
Name:APODACA, KINSEY R (ARNP)
Entity type:Individual
Prefix:
First Name:KINSEY
Middle Name:R
Last Name:APODACA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2425 MILLSTREAM AVE
Mailing Address - Street 2:
Mailing Address - City:WINTERSET
Mailing Address - State:IA
Mailing Address - Zip Code:50273-8124
Mailing Address - Country:US
Mailing Address - Phone:515-689-2531
Mailing Address - Fax:
Practice Address - Street 1:330 LAUREL ST STE 2100
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-3068
Practice Address - Country:US
Practice Address - Phone:515-358-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA179171363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily