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NPI Code Detail

MEDICARE: SHELLY F KIRK NP

MEDICARE: SHELLY F KIRK NP
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
1363L00000XNurse Practitioner1966924405UT
2363L00000XNurse Practitioner238878AZ

General Provider Information

NPI Number : 1932229259
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELLY F KIRK NP
Provider Business Mailing Address
First Line : 14044 W CAMELBACK RD STE 118
Second Line :
City : LITCHFIELD PARK
State : AZ
Zip : 85340-9481
Country : US
Telephone Number : 623-547-2600
Fax Number : 623-547-1899
Provider Business Practice Location Address
First Line : 14044 W CAMELBACK RD STE 118
Second Line :
City : LITCHFIELD PARK
State : AZ
Zip : 85340-9481
Country : US
Telephone Number : 623-547-2600
Fax Number : 623-547-1899
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2007
Last Update Date : 05/20/2024

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Directions to “ SHELLY F KIRK NP” Practice Location

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