Provider Demographics
NPI:1073815155
Name:KIRKMAN, ASHLEY ANN (ATC, OTC)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:ANN
Last Name:KIRKMAN
Suffix:
Gender:F
Credentials:ATC, OTC
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:ANN
Other - Last Name:CANFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC, OTC
Mailing Address - Street 1:4031 W PLANO PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5617
Mailing Address - Country:US
Mailing Address - Phone:972-985-1072
Mailing Address - Fax:972-985-1072
Practice Address - Street 1:4031 W PLANO PKWY STE 100
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5617
Practice Address - Country:US
Practice Address - Phone:972-985-1072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-23
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
156FX1900X
GAAT0017492255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No156FX1900XEye and Vision Services ProvidersTechnician/TechnologistOrthoptistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1073815155OtherNA