MEDICARE: MS. LINDA J KIRK ACNS-BC

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
1	364SM0705X	Medical-Surgical Clinical Nurse Specialist	440622	TX

General Provider Information

NPI Number	:	1720190762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINDA J KIRK ACNS-BC

Provider Business Mailing Address
First Line	:	215 E QUINCY ST STE 610
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78215-2031
Country	:	US
Telephone Number	:	210-226-2001
Fax Number	:	210-228-0421

Provider Business Practice Location Address
First Line	:	215 E QUINCY ST STE 610
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78215-2031
Country	:	US
Telephone Number	:	210-226-2001
Fax Number	:	210-228-0421

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/03/2008

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