Individual
MRS. BEVERLY J. KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2707 N BARACK OBAMA BLVD, VALDOSTA, GA 31602-2057
(229) 316-8116
Mailing address
PO BOX 749, OCILLA, GA 31774-0749
(229) 468-9166
(229) 468-9188
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
GAA-NP000575
GA
Other
Enumeration date
02/09/2009
Last updated
03/03/2022
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