Individual
KATHY A KIRKEBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
820 4TH ST N, FARGO, ND 58122-0001
(701) 234-7544
(701) 234-7577
Mailing address
820 4TH ST N, FARGO, ND 58122-0001
(701) 234-7544
(701) 234-7577
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PAC0130
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
430620100
—
MN
05
—
71174
—
ND
Enumeration date
07/22/2006
Last updated
11/21/2012
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