Healthcare Provider Details

I. General information

NPI: 1760460869
Provider Name (Legal Business Name): GAIL ELIZABETH KIRBY ANP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 04/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 W CHURCH ST
GREER SC
29650-1907
US

IV. Provider business mailing address

203 MILLS AVE
GREENVILLE SC
29605-4019
US

V. Phone/Fax

Practice location:
  • Phone: 864-271-1844
  • Fax: 864-271-2147
Mailing address:
  • Phone: 864-271-1844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN2175
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: