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NPI Code Detail

MEDICARE: KATHLEEN SUZANNE SHIRKEY REGISTERED NURSE

MEDICARE: KATHLEEN SUZANNE SHIRKEY REGISTERED NURSE
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
1163WA0400XAddiction (Substance Use Disorder) Registered Nurse4704234553MI

General Provider Information

NPI Number : 1992882443
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN SUZANNE SHIRKEY REGISTERED NURSE
Provider Business Mailing Address
First Line : 36863 BORDMAN RD
Second Line :
City : RILEY
State : MI
Zip : 48041-4506
Country : US
Telephone Number : 810-392-8436
Fax Number :
Provider Business Practice Location Address
First Line : 400 STODDARD RD
Second Line :
City : RICHMOND
State : MI
Zip : 48062-2505
Country : US
Telephone Number : 810-392-2167
Fax Number : 810-392-3481
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 07/08/2007

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Directions to “ KATHLEEN SUZANNE SHIRKEY REGISTERED NURSE” Practice Location

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