Provider Demographics
NPI:1063215432
Name:KINNEY, DAVID ALAN JR (RN)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:ALAN
Last Name:KINNEY
Suffix:JR
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6609 E 143RD ST N
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74021-4590
Mailing Address - Country:US
Mailing Address - Phone:918-924-0561
Mailing Address - Fax:
Practice Address - Street 1:1 W 36TH ST N STE 1
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74106-1703
Practice Address - Country:US
Practice Address - Phone:918-425-4200
Practice Address - Fax:918-560-1399
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK204716163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse