Individual
PATRICIA L. KINKEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
35391 JACKMAN AVE, WARSAW, MO 65355-6153
(660) 221-9646
Mailing address
35391 JACKMAN AVE, WARSAW, MO 65355-6153
(660) 221-9646
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2003000854
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
MOLINA HEALTHCARE
MO
05
—
PENDING
—
MO
Enumeration date
08/07/2008
Last updated
11/21/2016
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