Individual
CHARLES M KIRKSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
166 HOSPITAL ST, MONTICELLO, KY 42633-2416
(606) 348-9343
(606) 348-0333
Mailing address
166 HOSPITAL ST, MONTICELLO, KY 42633-2416
(606) 348-9343
(606) 348-0333
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3002657
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000108553
ANTHEM BC & BS
KY
01
—
610847215
CHA HEALTH
KY
01
—
610847215001
TRICARE
KY
05
—
74009887
—
KY
05
—
74900994
—
KY
Enumeration date
05/27/2006
Last updated
09/13/2016
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