Individual
KATHLEEN A KINNAMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN-FNP
Contact information
Practice address
300 N MORLEY ST, STE A-C, MOBERLY, MO 65270-2334
(660) 263-1225
(660) 263-1613
Mailing address
670 MASON RIDGE CENTER DR, STE 300, SAINT LOUIS, MO 63141-8573
(660) 263-1225
(660) 263-1613
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
503229
TX
363LF0000X
Family Nurse Practitioner
Primary
2015012531
MO
363LF0000X
Family Nurse Practitioner
503229
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
198344701
—
TX
Enumeration date
10/02/2008
Last updated
12/11/2015
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