Provider Demographics
NPI:1386968956
Name:KIRKMAN, JUANITA (LPN)
Entity type:Individual
Prefix:MRS
First Name:JUANITA
Middle Name:
Last Name:KIRKMAN
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 1:175 MAIN STREET
Mailing Address - Street 2:A & A STAFFING
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601
Mailing Address - Country:US
Mailing Address - Phone:914-428-1515
Mailing Address - Fax:914-425-0862
Practice Address - Street 1:175 MAIN STREET
Practice Address - Street 2:A & A STAFFING
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601
Practice Address - Country:US
Practice Address - Phone:914-428-1515
Practice Address - Fax:914-425-0862
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY098329-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse