Provider Demographics
NPI:1437997707
Name:KINSLOW, LUCIE VICTORIA
Entity type:Individual
Prefix:
First Name:LUCIE
Middle Name:VICTORIA
Last Name:KINSLOW
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 1:756 CAP LN
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-4859
Mailing Address - Country:US
Mailing Address - Phone:614-625-2211
Mailing Address - Fax:
Practice Address - Street 1:10719 WHITE FIR LN
Practice Address - Street 2:
Practice Address - City:GALENA
Practice Address - State:OH
Practice Address - Zip Code:43021-7039
Practice Address - Country:US
Practice Address - Phone:614-353-5618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant