Provider Demographics
NPI:1376343228
Name:KIRKPATRICK, MELORIA
Entity type:Individual
Prefix:
First Name:MELORIA
Middle Name:
Last Name:KIRKPATRICK
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 1:19762 380TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:IA
Mailing Address - Zip Code:51560-4220
Mailing Address - Country:US
Mailing Address - Phone:712-310-5031
Mailing Address - Fax:
Practice Address - Street 1:1401 E GOLD COAST RD STE 430
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-5748
Practice Address - Country:US
Practice Address - Phone:712-310-5031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant