Provider Demographics
NPI:1558125864
Name:KIRKLAND, LINDSEY A (RN-BSN, RPSGT, CCSH)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:A
Last Name:KIRKLAND
Suffix:
Gender:F
Credentials:RN-BSN, RPSGT, CCSH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 PALIN DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-6962
Mailing Address - Country:US
Mailing Address - Phone:601-613-6389
Mailing Address - Fax:
Practice Address - Street 1:1500 E WOODROW WILSON AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-5116
Practice Address - Country:US
Practice Address - Phone:601-613-6389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
15917235500000X
064246Z00000X
MS919963163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist
No246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other