Individual
MS. NICOLE DAYNA KIRKSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1442 STRUBLE AVE NE, CANTON, OH 44705-1253
(330) 830-6317
Mailing address
1442 STRUBLE AVE NE, CANTON, OH 44705-1253
(330) 455-2739
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
RV046173
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2509413
—
OH
Enumeration date
03/06/2007
Last updated
07/09/2007
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