Provider Demographics
NPI:1407616261
Name:KIRKLAND, FAYE REGINA
Entity Type:Individual
Prefix:
First Name:FAYE
Middle Name:REGINA
Last Name:KIRKLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 C ST SE APT 11
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-2347
Mailing Address - Country:US
Mailing Address - Phone:202-731-7847
Mailing Address - Fax:
Practice Address - Street 1:4402 QUARLES ST NE APT 13
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-2070
Practice Address - Country:US
Practice Address - Phone:202-731-7847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant