Individual
CARRIE KIRK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7509 CHARLESTOWN PIKE, CHARLESTOWN, IN 47111-9623
(812) 256-4686
Mailing address
13013 HIGHWAY 60, MEMPHIS, IN 47143-9609
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
27057708A
IN
Other
Enumeration date
12/29/2009
Last updated
12/29/2009
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