Provider Demographics
NPI:1073280467
Name:KIRBY, LINDA JOYCE (NP)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:JOYCE
Last Name:KIRBY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6857 HILO AVE
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72019-8867
Mailing Address - Country:US
Mailing Address - Phone:501-860-9846
Mailing Address - Fax:
Practice Address - Street 1:6857 HILO AVE
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72019-8867
Practice Address - Country:US
Practice Address - Phone:501-860-9846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR214627363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily