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Individual
JACQUELYN KIRBY
Active
Individual
JACQUELYN KIRBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5363P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000545943
BCBS
KY
05
—
31000458
—
KY
01
—
611268014
FEDERAL TAX ID
—
Enumeration date
10/09/2007
Last updated
12/20/2019
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