Individual
MS. SUSAN H KIRBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2041 MESA VALLEY WAY, SUITE 100, AUSTELL, GA 30106-6828
(770) 944-1100
(770) 944-6469
Mailing address
2041 MESA VALLEY WAY, SUITE 100, AUSTELL, GA 30106-6828
(770) 944-1100
(770) 944-6469
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
F0207056
GA
363L00000X
Nurse Practitioner
Primary
RN157966
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
475644168A
—
GA
05
—
475644168B
—
GA
05
—
475644168C
—
GA
Enumeration date
05/04/2007
Last updated
02/05/2009
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