Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 1-100479 | AL |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 1-100479 | AL |
NPI | 1003392036 |
---|---|
Provider Name | Katherine Kinsaul |
First Address | Mobile, AL 36608-1389 |
Second Address | Mobile, AL 36607-3513 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2018 |
Last Update Date | 18/08/2021 |