Provider Demographics
NPI:1346785839
Name:KIRTLEY, NORIE (NP)
Entity Type:Individual
Prefix:
First Name:NORIE
Middle Name:
Last Name:KIRTLEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3205 N ACADEMY BLVD
Mailing Address - Street 2:STE 130
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-5152
Mailing Address - Country:US
Mailing Address - Phone:719-344-6914
Mailing Address - Fax:719-344-7865
Practice Address - Street 1:11115 W. HWY 24
Practice Address - Street 2:UNIT 2C
Practice Address - City:DIVIDE
Practice Address - State:CO
Practice Address - Zip Code:80814-0928
Practice Address - Country:US
Practice Address - Phone:719-687-6416
Practice Address - Fax:719-687-6501
Is Sole Proprietor?:No
Enumeration Date:2016-12-20
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CORN.0201289163W00000X
COAPN.0994152-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse