Individual
MS. THERESA M. KINNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
202D00000X
Integrative Medicine Physician
Primary
124572
MT
261QP2300X
Primary Care Clinic/Center
APRN124572
MT
363LA2200X
Adult Health Nurse Practitioner
124572
MT
Other
Enumeration date
02/20/2017
Last updated
02/20/2025
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