Krista S Kinkennon, NP
Individual provider Active NPI Nurse Practitioner · Ogden, IA
NPI 1174408348 · NPPES record last updated Aug 7, 2025
Key facts
- NPI
- 1174408348
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 11019372 (IA)
- Practice address
- 1014 230TH St
Ogden, IA 50212-7528 - Phone
- (786) 309-8495
- NPI assigned
- Aug 7, 2025
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11019372 | IA | MD | Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner |
363L00000X | 11019372 | IA | Yes |
Addresses
Primary practice location
1014 230TH St
Ogden, IA 50212-7528
Mailing address
1014 230TH St
Ogden, IA 50212-7528
Phone (786) 309-8495
Other providers in Ogden, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 7, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.