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NPI Code Detail

MEDICARE: MS. KELLY ELIZABETH KIRKPATRICK MS, LAT, ATC

MEDICARE:  MS. KELLY ELIZABETH KIRKPATRICK  MS, LAT, ATC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic Trainer1892NC

General Provider Information

NPI Number : 1487910758
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KELLY ELIZABETH KIRKPATRICK MS, LAT, ATC
Provider Business Mailing Address
First Line : 1735 LEWISVILLE CLEMMONS ROAD
Second Line : WEST FORSYTH HIGH SCHOOL
City : CLEMMONS
State : NC
Zip : 27012
Country : US
Telephone Number : 336-399-5954
Fax Number :
Provider Business Practice Location Address
First Line : 1735 LEWISVILLE CLEMMONS ROAD
Second Line : WEST FORSYTH HIGH SCHOOL
City : CLEMMONS
State : NC
Zip : 27012
Country : US
Telephone Number : 336-399-5954
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2012
Last Update Date : 04/11/2012

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Directions to “ MS. KELLY ELIZABETH KIRKPATRICK MS, LAT, ATC” Practice Location

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