Provider Demographics
NPI:1831322767
Name:KIRKMAN, ROBIN RENEE (LICENSED PRACTICAL N)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:RENEE
Last Name:KIRKMAN
Suffix:
Gender:F
Credentials:LICENSED PRACTICAL N
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:RENEE
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICENSED PRACTICAL N
Mailing Address - Street 1:9299 INDIAN LAKE RD.
Mailing Address - Street 2:
Mailing Address - City:BYESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43723
Mailing Address - Country:US
Mailing Address - Phone:740-685-9130
Mailing Address - Fax:
Practice Address - Street 1:9299 INDIAN LAKE RD.
Practice Address - Street 2:
Practice Address - City:BYESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43723
Practice Address - Country:US
Practice Address - Phone:740-685-9130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN-094876164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse