Provider Demographics
NPI:1336731082
Name:KIRKMAN, ALICIA R
Entity Type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:R
Last Name:KIRKMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7820 EVE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-4153
Mailing Address - Country:US
Mailing Address - Phone:216-288-2412
Mailing Address - Fax:
Practice Address - Street 1:7820 EVE AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-4153
Practice Address - Country:US
Practice Address - Phone:216-288-2412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401986280717376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide