Provider Demographics
NPI:1588932933
Name:KIRKESY-GARNER, PARIS LAQUAE (LPN)
Entity type:Individual
Prefix:
First Name:PARIS
Middle Name:LAQUAE
Last Name:KIRKESY-GARNER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:PARIS
Other - Middle Name:LAQUAE
Other - Last Name:GARNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPN
Mailing Address - Street 1:5144 OAKMONT DR
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2721
Mailing Address - Country:US
Mailing Address - Phone:216-640-1448
Mailing Address - Fax:
Practice Address - Street 1:5144 OAKMONT DR
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-2721
Practice Address - Country:US
Practice Address - Phone:216-640-1448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-13
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH134817164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse