Provider Demographics
NPI:1790218428
Name:KIRKPATRICK, KAITLIN VICTORIA
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:VICTORIA
Last Name:KIRKPATRICK
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 1:999 N 92ND ST
Mailing Address - Street 2:MEDICAL EDUCATION OFFICE, SUITE 730
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4875
Mailing Address - Country:US
Mailing Address - Phone:414-337-7030
Mailing Address - Fax:
Practice Address - Street 1:999 N 92ND ST
Practice Address - Street 2:MEDICAL EDUCATION OFFICE, SUITE 730
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-4875
Practice Address - Country:US
Practice Address - Phone:414-337-7030
Practice Address - Fax:414-337-7068
Is Sole Proprietor?:No
Enumeration Date:2017-04-10
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program