William Leon Kirksey, LPN

Individual provider Active NPI Licensed Practical Nurse · Shaker HTS, OH

NPI 1891937009 · NPPES record last updated Apr 2, 2009

Key facts

NPI
1891937009
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
PN122633 (OH)
Practice address
2575 Kemper Rd
Apt a-2
Shaker HTS, OH 44120-1276
Phone
(216) 324-0614
NPI assigned
Apr 2, 2009
Sex
Male
Sole proprietor
Yes

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
PN122633OHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN122633 OH Yes

Addresses

Primary practice location

2575 Kemper Rd
Apt a-2
Shaker HTS, OH 44120-1276

Mailing address

2575 Kemper Rd
Apt a-2
Shaker HTS, OH 44120-1276
Phone (216) 324-0614

Other providers in Shaker HTS, OH

All providers in Shaker HTS, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.