Provider Demographics
NPI:1013317270
Name:DONKOR, KIRSTEN (ATC)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:
Last Name:DONKOR
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 SAMUEL MILLER LOOP
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-7527
Mailing Address - Country:US
Mailing Address - Phone:434-823-4805
Mailing Address - Fax:
Practice Address - Street 1:1000 SAMUEL MILLER LOOP
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-7527
Practice Address - Country:US
Practice Address - Phone:434-823-4805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-25
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260014832255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer