Provider Demographics
NPI:1902599061
Name:KIRK, KARI BETH
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:BETH
Last Name:KIRK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1848 RIDGEWAY DR
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-5631
Mailing Address - Country:US
Mailing Address - Phone:405-493-4429
Mailing Address - Fax:
Practice Address - Street 1:1848 RIDGEWAY DR
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-5631
Practice Address - Country:US
Practice Address - Phone:405-493-4429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist