Provider Demographics
NPI:1710571823
Name:KIRKES, LACY (MSN, RN)
Entity Type:Individual
Prefix:
First Name:LACY
Middle Name:
Last Name:KIRKES
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 ARIANA CT
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-5747
Mailing Address - Country:US
Mailing Address - Phone:254-449-0857
Mailing Address - Fax:
Practice Address - Street 1:3404 KAYDENCE CT
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-3338
Practice Address - Country:US
Practice Address - Phone:254-553-6029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX801275163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse