Provider Demographics
NPI:1982412920
Name:KIRKLAND, CHRISTAN DESHEA' (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:CHRISTAN
Middle Name:DESHEA'
Last Name:KIRKLAND
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9748 EVANS RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32208-1524
Mailing Address - Country:US
Mailing Address - Phone:904-403-8091
Mailing Address - Fax:
Practice Address - Street 1:9748 EVANS RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32208-1524
Practice Address - Country:US
Practice Address - Phone:904-403-8091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9523960163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse