Provider Demographics
NPI:1023051794
Name:BARKSDALE, KATHLEEN KIRBY (NP)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:KIRBY
Last Name:BARKSDALE
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:1201 BROAD ROCK BLVD
Mailing Address - Street 2:BOX 111-K
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23249-0001
Mailing Address - Country:US
Mailing Address - Phone:804-675-5446
Mailing Address - Fax:804-675-5290
Practice Address - Street 1:1201 BROAD ROCK BLVD
Practice Address - Street 2:BOX 111-K
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23249-0001
Practice Address - Country:US
Practice Address - Phone:804-675-5446
Practice Address - Fax:804-675-5290
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024045279363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner