Provider Demographics
NPI:1740686369
Name:KIRK, ROBERT CHRISTOPHER (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:CHRISTOPHER
Last Name:KIRK
Suffix:
Gender:
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:739 S WHITE HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:NJ
Mailing Address - Zip Code:08106-1659
Mailing Address - Country:US
Mailing Address - Phone:856-546-2300
Mailing Address - Fax:856-546-2301
Practice Address - Street 1:739 S WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:NJ
Practice Address - Zip Code:08106-1659
Practice Address - Country:US
Practice Address - Phone:856-546-2300
Practice Address - Fax:856-546-2301
Is Sole Proprietor?:No
Enumeration Date:2014-11-10
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014185363LP0808X
NJ26NJ005333100363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health