Provider Demographics
NPI:1194888347
Name:HULSEY, KIRVEN PIE (CNM, FNP-C)
Entity type:Individual
Prefix:
First Name:KIRVEN
Middle Name:PIE
Last Name:HULSEY
Suffix:
Gender:F
Credentials:CNM, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:591 BRADY RD
Mailing Address - Street 2:
Mailing Address - City:AMERICUS
Mailing Address - State:GA
Mailing Address - Zip Code:31709-5606
Mailing Address - Country:US
Mailing Address - Phone:229-924-1489
Mailing Address - Fax:
Practice Address - Street 1:100 WHEATLEY DR
Practice Address - Street 2:SUITE 301
Practice Address - City:AMERICUS
Practice Address - State:GA
Practice Address - Zip Code:31709-3788
Practice Address - Country:US
Practice Address - Phone:229-928-2900
Practice Address - Fax:229-928-2682
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN044410363LF0000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Not Answered367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00352338AMedicaid
GAR74739Medicare UPIN
GA00352338AMedicaid