Individual
JASMINE DARNIECE KIRKLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
6001 PROFESSIONAL PKWY STE 2020, DOUGLASVILLE, GA 30134-5632
(470) 956-1570
Mailing address
6001 PROFESSIONAL PKWY STE 2020, DOUGLASVILLE, GA 30134-5632
(470) 956-1570
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
23045
TX
363LF0000X
Family Nurse Practitioner
Primary
AP133880
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0035TD
BLUE CROSS BLUE SHIELD OF TEXAS GRP REC #
TX
05
—
153449704
—
TX
Enumeration date
06/21/2017
Last updated
06/23/2021
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