Provider Demographics
NPI:1982953667
Name:KIRKER, BRIANNE ELIZABETH (LPN)
Entity Type:Individual
Prefix:MS
First Name:BRIANNE
Middle Name:ELIZABETH
Last Name:KIRKER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 ANDREWS AVE
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45121-1003
Mailing Address - Country:US
Mailing Address - Phone:937-690-9014
Mailing Address - Fax:
Practice Address - Street 1:309 ANDREWS AVE
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:OH
Practice Address - Zip Code:45121-1003
Practice Address - Country:US
Practice Address - Phone:937-690-9014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-10
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH116999164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse