Provider Demographics
NPI:1548134240
Name:KINER, KAYSHA L
Entity type:Individual
Prefix:MS
First Name:KAYSHA
Middle Name:L
Last Name:KINER
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 1:493 WYOMING AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215-3135
Mailing Address - Country:US
Mailing Address - Phone:716-844-9421
Mailing Address - Fax:
Practice Address - Street 1:493 WYOMING AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-3135
Practice Address - Country:US
Practice Address - Phone:716-844-9421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-03
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY757218163WG0000X, 163WX1500X, 163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WX1500XNursing Service ProvidersRegistered NurseOstomy Care
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator