Individual
MALONNIE L KINNISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4021 AVENUE B, SCOTTSBLUFF, NE 69361-4602
(303) 761-9190
(303) 761-6278
Mailing address
10700 E GEDDES AVE, SUITE 200, ENGLEWOOD, CO 80112-3800
(303) 761-9190
(303) 761-6278
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
24920
NE
2085R0202X
Diagnostic Radiology Physician
D0027477
MD
2085R0204X
Vascular & Interventional Radiology Physician
Primary
D0027477
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
439851300
—
MD
Enumeration date
06/10/2006
Last updated
08/17/2015
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