Doctor Name: | BRANDI NICOLE KINCAID |
NPI Number: | 1144527490 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSN, APRN, NP-C |
License Number: | 2011005105 |
Business Practice Address: | 54 Hospital Dr Osage Beach, MO - 650653050 |
Business Phone Number: | 5733022772 |
Business Fax Number: | 5733022264 |
Mailing Address: | Po Box 1500, OSAGE BEACH |
State: | MO |
Postal Code: | 650651500 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 02/23/2011 |
NPI Last Update Date: | 03/07/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 2011005105 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |