Provider Demographics
NPI:1225861313
Name:KINSEY, SHAWNTEE S
Entity type:Individual
Prefix:
First Name:SHAWNTEE
Middle Name:S
Last Name:KINSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8575 MERCHANTS WAY APT 532
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32222-2957
Mailing Address - Country:US
Mailing Address - Phone:904-892-0330
Mailing Address - Fax:
Practice Address - Street 1:8575 MERCHANTS WAY APT 532
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32222-2957
Practice Address - Country:US
Practice Address - Phone:904-892-0330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL320825376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide