Kinkade, Timothy E

Kinkade, Timothy E is an individual health care provider with primary practice located at 404 Jefferson St , Pella IA 50219-1257. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Kinkade, Timothy E can be contacted via phone (641) 628-6634.

Contact Information

Primary practice address
404 Jefferson St Pella IA 50219-1257
Phone: (641) 628-6634
Fax: (913) 381-0979
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 058017 Iowa

Profile Details

NPI number 1417902909
LBN Legal business name Kinkade, Timothy E
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2006
Last updated May 2nd, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417902909 NPPES
Iowa MEDICAID 3265819

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