Provider Demographics
NPI:1265394365
Name:KINDER, JENNIFER MARIE (AGPCNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARIE
Last Name:KINDER
Suffix:
Gender:F
Credentials:AGPCNP
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:
Other - Last Name:KINDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AGPCNP
Mailing Address - Street 1:1315 YORK AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5304
Mailing Address - Country:US
Mailing Address - Phone:646-962-2270
Mailing Address - Fax:
Practice Address - Street 1:1315 YORK AVE FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5304
Practice Address - Country:US
Practice Address - Phone:646-962-2270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-26
Last Update Date:2025-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF312535-01363LG0600X, 363LP2300X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care