Individual
SUSAN KIRKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
317 N ENGLISH ST, LEITCHFIELD, KY 42754-2228
(502) 550-4164
Mailing address
317 N ENGLISH ST, LEITCHFIELD, KY 42754-2228
(502) 550-4164
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1048153 2125A
KY
367500000X
Certified Registered Nurse Anesthetist
295272
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000669363
ANTHEM
—
05
—
200487620
—
IN
05
—
2491049
—
OH
01
—
412840118
MEDICARE
IN
01
—
611077369 1295716850
HEALTHNET
—
05
—
7100004550
—
KY
Enumeration date
07/13/2005
Last updated
05/25/2022
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