Provider Demographics
NPI:1316410780
Name:KIRKLAND, MELANIE NICOLE (RN (RNFA))
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:NICOLE
Last Name:KIRKLAND
Suffix:
Gender:F
Credentials:RN (RNFA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 W 1ST ST APT 1219
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76102-2762
Mailing Address - Country:US
Mailing Address - Phone:940-312-3960
Mailing Address - Fax:
Practice Address - Street 1:901 W 1ST ST APT 1219
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76102-2762
Practice Address - Country:US
Practice Address - Phone:940-312-3960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX847058163WX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0800XNursing Service ProvidersRegistered NurseOrthopedic