Individual
MRS. STACY M KIRBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1815 - 1ST AVE SE, SUITE 200, CEDAR RAPIDS, IA 52402-5417
(319) 363-0474
(319) 363-2170
Mailing address
1815 - 1ST AVE SE, SUITE 200, CEDAR RAPIDS, IA 52402-5417
(319) 363-0474
(319) 363-2170
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
001929
IA
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962610725
—
IA
Enumeration date
07/13/2008
Last updated
08/06/2013
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