Provider Demographics
NPI:1902209075
Name:KIRK, LINDA WHITNEY (RN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:WHITNEY
Last Name:KIRK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:PROSSER
Mailing Address - State:WA
Mailing Address - Zip Code:99350-1522
Mailing Address - Country:US
Mailing Address - Phone:509-786-1732
Mailing Address - Fax:509-786-2814
Practice Address - Street 1:2001 HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:PROSSER
Practice Address - State:WA
Practice Address - Zip Code:99350-1522
Practice Address - Country:US
Practice Address - Phone:509-786-1732
Practice Address - Fax:509-786-2814
Is Sole Proprietor?:No
Enumeration Date:2014-10-03
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00138928163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool