Individual
NANCY L KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8444 W 21ST ST N, WICHITA, KS 67205-1752
(316) 721-9500
(316) 721-9574
Mailing address
PO BOX 764, WICHITA, KS 67201-0764
(316) 268-8123
(316) 291-7716
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-01070
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200354270A
—
KS
Enumeration date
03/27/2006
Last updated
11/30/2010
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