Individual
KIMBERLY MARIA KIRKUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
926 ASPEN ST, FAIRBANKS, AK 99709-5501
(907) 371-1300
(907) 563-2045
Mailing address
1423 PEGER RD, FAIRBANKS, AK 99709-5169
(907) 371-1300
(907) 561-1416
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
38518
AK
163WP0808X
Psychiatric/Mental Health Registered Nurse
680792-1
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
211949
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
211949
ADVANCED PRACTICE REGISTERED NURSE
AK
01
—
38518
REGISTERED NURSE
AK
01
—
680792-01
REGISTERED NURSE LICENSE
NY
Enumeration date
06/22/2023
Last updated
01/08/2024
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