Individual
TRACEY LYNN KIRK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
13 E. MILL ST., BROOKLYN, IN 46111
(317) 834-3714
Mailing address
13 E. MILL ST., PO BOX 18, BROOKLYN, IN 46111
(317) 834-3714
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
27045519A
IN
Other
Enumeration date
05/31/2007
Last updated
07/08/2007
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