Provider Demographics
NPI:1417688086
Name:JERRICA KIRKLEY M.D., P.C.
Entity Type:Organization
Organization Name:JERRICA KIRKLEY M.D., P.C.
Other - Org Name:PLUME HEALTH
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR OF ACCOUNTING
Authorized Official - Prefix:
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILENSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-632-3463
Mailing Address - Street 1:303 S. BROADWAY
Mailing Address - Street 2:#200-357
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209
Mailing Address - Country:US
Mailing Address - Phone:720-248-4483
Mailing Address - Fax:
Practice Address - Street 1:633 WEST FIFTH ST.
Practice Address - Street 2:28TH FLOOR OFFICE 2848
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90071
Practice Address - Country:US
Practice Address - Phone:720-248-4483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-23
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty