Individual
DR. JESSICA LYNN KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4414 LAKE BOONE TRL, SUITE 408, RALEIGH, NC 27607-7513
(919) 781-1001
(919) 781-3909
Mailing address
4414 LAKE BOONE TRL, SUITE 408, RALEIGH, NC 27607-7513
(919) 781-1001
(919) 781-3909
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
2015-00856
NC
207N00000X
Dermatology Physician
LP01457
RI
390200000X
Student in an Organized Health Care Education/Training Program
MT191132
PA
Other
Enumeration date
07/20/2007
Last updated
10/28/2015
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