# KIRK D ASHBURN II

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1790782845
- **Gender:** Man
- **Credential:** A.R.N.P.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207N00000X | Dermatology Physician | 71001760A | IN | — |
| 363L00000X | Nurse Practitioner | 71001760A | IN | Yes |

## Other

- **Enumeration date:** 07/05/2005
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000387509 | ANTHEM PIN | IN |
| 05 | — | 200207810 | — | IN |
| 01 | — | P00333134 | RAILROAD MEDICARE | IN |