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General NPI Number Information
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NPI Number | 1922455666
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Entity Type | Individual
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Provider Name | AIDIA KIRKSEY
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Gender | Female
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Dates
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Enumeration Date | 05/23/2016
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Last Update Date | 06/01/2018
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Provider Practice Location Address
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Address Line | 114 SAND PINE TRL
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City | CRAWFORDVILLE
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State | FL
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Zip | 32327
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Country | US
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Telephone | 850-556-0904
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Fax | 850-888-3058
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Provider Business Mailing Address
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Address Line | 114 SAND PINE TRL
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City | CRAWFORDVILLE
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State | FL
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Zip | 32327-1253
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Country | US
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Telephone | 850-556-0904
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Fax | 850-888-3058
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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