Provider Demographics
NPI:1750497871
Name:KIRBY, (DODIE) DORIS J (LPN)
Entity Type:Individual
Prefix:MRS
First Name:(DODIE) DORIS
Middle Name:J
Last Name:KIRBY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7579 OLD WEST HENRY RD
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:OH
Mailing Address - Zip Code:45167-9777
Mailing Address - Country:US
Mailing Address - Phone:937-377-6030
Mailing Address - Fax:937-377-6030
Practice Address - Street 1:7579 OLD WEST HENRY RD
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:OH
Practice Address - Zip Code:45167-9777
Practice Address - Country:US
Practice Address - Phone:937-377-6030
Practice Address - Fax:937-377-6030
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN026213164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse