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Individual

ELAINE KIRK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
259 W MAIN ST, DECATURVILLE, TN 38329-8033
(731) 852-3112
(731) 852-3222
Mailing address
19370 HIGHWAY 57, MIDDLETON, TN 38052-4427
(731) 852-3112
(731) 852-3222

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APN 6251
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
600019378
TN
Enumeration date
11/14/2006
Last updated
07/09/2007
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