Individual
KACY MIKALA KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1803 N JACKSON ST, TULLAHOMA, TN 37388-2201
(931) 455-3400
Mailing address
183 ROBERTS CREEK CIR, MANCHESTER, TN 37355-3690
(931) 607-2531
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
22311
TN
Other
Enumeration date
02/08/2017
Last updated
11/12/2021
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