Provider Demographics
NPI:1225251333
Name:KIRKER ECONOMOS, JOANN K (MSN, RN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JOANN
Middle Name:K
Last Name:KIRKER ECONOMOS
Suffix:
Gender:F
Credentials:MSN, RN, FNP-BC
Other - Prefix:
Other - First Name:JOANN
Other - Middle Name:K
Other - Last Name:ECONOMOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:1250 KINGS HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-6596
Mailing Address - Country:US
Mailing Address - Phone:302-604-0370
Mailing Address - Fax:302-644-2991
Practice Address - Street 1:1250 KINGS HIGHWAY
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-6596
Practice Address - Country:US
Practice Address - Phone:302-604-0370
Practice Address - Fax:302-644-2991
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0013665163W00000X
DELG-0000297363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse