Healthcare Provider Details

I. General information

NPI: 1265157788
Provider Name (Legal Business Name): M'KAYLEE ANN KIRBY FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2022
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 E 1ST ST
PRATT KS
67124-2052
US

IV. Provider business mailing address

PO BOX 99
KINSLEY KS
67547-0099
US

V. Phone/Fax

Practice location:
  • Phone: 620-770-8181
  • Fax:
Mailing address:
  • Phone: 620-659-3621
  • Fax: 620-659-3869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number137500
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: