Healthcare Provider Details

I. General information

NPI: 1619812559
Provider Name (Legal Business Name): EMILY KIRKSEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 STOKESAY ST
LUDLOW KY
41016-1357
US

IV. Provider business mailing address

215 STOKESAY ST
LUDLOW KY
41016-1357
US

V. Phone/Fax

Practice location:
  • Phone: 859-287-4708
  • Fax:
Mailing address:
  • Phone: 859-287-4708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number4003429
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: