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NPI Code Detail

MEDICARE: MRS. DONNA M. KIRK APRN

MEDICARE:  MRS. DONNA M. KIRK  APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner3004346KY

General Provider Information

NPI Number : 1548310014
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DONNA M. KIRK APRN
Provider Business Mailing Address
First Line : 9200 SHELBYVILLE RD
Second Line : STE 530
City : LOUISVILLE
State : KY
Zip : 40222-5144
Country : US
Telephone Number : 502-327-9100
Fax Number : 855-632-8329
Provider Business Practice Location Address
First Line : 2100 MILLVALE RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40205-1604
Country : US
Telephone Number : 502-451-0990
Fax Number : 502-459-1018
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2007
Last Update Date : 12/18/2017

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