Provider Demographics
NPI:1942357587
Name:U.S. ARMY
Entity Type:Organization
Organization Name:U.S. ARMY
Other - Org Name:KIRK U.S. ARMY HEALTH CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:PRESPER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:410-278-1814
Mailing Address - Street 1:1252 EVERETTE RD
Mailing Address - Street 2:
Mailing Address - City:GUNPOWDER
Mailing Address - State:MD
Mailing Address - Zip Code:21010-1618
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2501 OAKINGTON ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN PROVING GROUND
Practice Address - State:MD
Practice Address - Zip Code:21005-5131
Practice Address - Country:US
Practice Address - Phone:410-278-1814
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT223451-4405314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility