HOLLY ROXANNE KINNELL-RUST FNP NPI 1932287893

NPI Information

NPI: 1932287893
Provider Name: HOLLY ROXANNE KINNELL-RUST, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
320 POMFRET ST
PUTNAM, CT
ZIP 06260
Phone: (860) 963-6371
Get Directions

Holly Roxanne Kinnell-rust, FNP is a family nurse practitioner in Putnam, CT with 23 years of experience. Holly Roxanne Kinnell-rust, FNP NPI is 1932287893. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

320 POMFRET ST
PUTNAM, CT
ZIP 06260-836
Phone: (860) 963-6371
Fax: (860) 963-6413

The NPI 1932287893 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/1/2006 and was last updated on 7/15/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		191964	MASSACHUSETTS	No
2	363LF0000X	Nurse Practitioner	Family	7023	CONNECTICUT	Yes
3	363LF0000X	Nurse Practitioner	Family	2010026851	MISSOURI	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P00859525	OTHER		RAILROAD MEDICARE
2	008073029	MEDICAID	CONNECTICUT
3	184085758	MEDICAID	ARKANSAS
4	1932287893	MEDICAID	MISSOURI
5	431560263	OTHER		TRICARE WEST

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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