MEDICARE: MISS KURSULA KIRBY KURSULA KIRBY, MPH

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
1	171400000X	Health & Wellness Coach
2	171M00000X	Case Manager/Care Coordinator
3	172V00000X	Community Health Worker
4	174H00000X	Health Educator
5	224P00000X	Prosthetist
6	372500000X	Chore Provider
7	372600000X	Adult Companion	CNA488504	FL
8	374U00000X	Home Health Aide
9	376K00000X	Nurse's Aide
10	133NN1002X	Nutrition Education Nutritionist

General Provider Information

NPI Number	:	1760873079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS KURSULA KIRBY KURSULA KIRBY, MPH

Provider Business Mailing Address
First Line	:	1500 W HIGHLAND ST LOT 227
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33815-4293
Country	:	US
Telephone Number	:	863-617-2314
Fax Number	:

Provider Business Practice Location Address
First Line	:	122 E MAIN ST # 111
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33801-4655
Country	:	US
Telephone Number	:	813-703-0533
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2015
Last Update Date	:	02/12/2026

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