Healthcare Provider Details

I. General information

NPI: 1558695726
Provider Name (Legal Business Name): MRS. LORI A. KIRKPATRICK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2009
Last Update Date: 09/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5511 HIGHWAY 280 SUITE 103
BIRMINGHAM AL
35242-6585
US

IV. Provider business mailing address

113 SOUTHLEDGE SUITE 101
BIRMINGHAM AL
35242-2451
US

V. Phone/Fax

Practice location:
  • Phone: 205-991-3141
  • Fax:
Mailing address:
  • Phone: 205-991-3141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number739A
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: