Individual
IAN S KINZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
4040 MEMORIAL PKWY SW, HUNTSVILLE, AL 35802-4364
(256) 533-1970
(256) 705-6477
Mailing address
4040 MEMORIAL PKWY SW, HUNTSVILLE, AL 35802-4364
(256) 533-1970
(256) 705-6477
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-147297
AL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1-147297
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
239778
—
AL
Enumeration date
10/17/2016
Last updated
10/27/2020
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