Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 1-095974 | AL |
NPI | 1295179083 |
---|---|
Provider Name | Mrs. Ashley Logan Kirkpatrick |
First Address | Warrior, AL 35180-2909 |
Second Address | Birmingham, AL 35249-1900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2013 |
Last Update Date | 23/04/2013 |