Provider Demographics
NPI:1093182180
Name:ROSS, KIRBY BUERKLEY (APRN)
Entity Type:Individual
Prefix:MRS
First Name:KIRBY
Middle Name:BUERKLEY
Last Name:ROSS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:909 KENTON STATION DR
Mailing Address - Street 2:
Mailing Address - City:MAYSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41056-9616
Mailing Address - Country:US
Mailing Address - Phone:606-759-4050
Mailing Address - Fax:606-759-1207
Practice Address - Street 1:927 KENTON STATION DR
Practice Address - Street 2:
Practice Address - City:MAYSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41056-9617
Practice Address - Country:US
Practice Address - Phone:606-759-0433
Practice Address - Fax:606-759-0058
Is Sole Proprietor?:No
Enumeration Date:2015-08-25
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY3009596363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0266707Medicaid
KY7100460070Medicaid