Kristy Kirk

Individual provider Active NPI Case Manager/Care Coordinator · Maxwelton, WV

NPI 1235905936 · NPPES record last updated Mar 19, 2024

Key facts

NPI
1235905936
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
804 Industrial Park Rd
Maxwelton, WV 24957-8066
Phone
(304) 497-0500
Fax
(304) 497-0516
NPI assigned
Dec 4, 2023
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2084P0800XWVMDPsychiatry Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 2084P0800X WV
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

804 Industrial Park Rd
Maxwelton, WV 24957-8066

Mailing address

804 Industrial Park Rd
Maxwelton, WV 24957-8066
Phone (304) 497-0500

Other providers in Maxwelton, WV

All providers in Maxwelton, WV · Case Manager/Care Coordinator in West Virginia

Sources for this page

Verify at the official NPI Registry.