Provider Demographics
NPI:1831900109
Name:KIRKSEY, JOEY A
Entity type:Individual
Prefix:
First Name:JOEY
Middle Name:A
Last Name:KIRKSEY
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 1:1423 FIELD ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48214-2321
Mailing Address - Country:US
Mailing Address - Phone:313-924-7860
Mailing Address - Fax:
Practice Address - Street 1:30555 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186-5310
Practice Address - Country:US
Practice Address - Phone:734-629-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider