Provider Demographics
NPI:1245596709
Name:NEWKIRK, MICHELLE A (LPN)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:A
Last Name:NEWKIRK
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 PRESTON AVE APT 105
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-1721
Mailing Address - Country:US
Mailing Address - Phone:609-332-1145
Mailing Address - Fax:
Practice Address - Street 1:900 DUDLEY AVE
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-4426
Practice Address - Country:US
Practice Address - Phone:856-361-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-09
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNEO5001164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse