Individual
BEVERLY H KINNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
358 MOUNTAIN VIEW RD, COPAKE, NY 12516-1239
(518) 392-3900
(518) 392-1040
Mailing address
PO BOX 2000, HUDSON, NY 12534-2000
(518) 828-8363
(518) 697-3388
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F302098
NY
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
360033
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01909517
—
NY
01
—
W79533
MEDICARE GROUP ; COLUMBIA MEMORIAL HOSPITAL
NY
Enumeration date
06/24/2006
Last updated
10/27/2008
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