Kirby Pool, LPN

Individual provider Active NPI Licensed Practical Nurse · Melbourne, AR

NPI 1932606563 · NPPES record last updated Apr 10, 2018

Key facts

NPI
1932606563
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
L055449 (AR)
Practice address
889 Main St
Melbourne, AR 72556-8205
Phone
(870) 368-4586
Fax
(870) 368-4587
NPI assigned
Apr 10, 2018
Sex
Female
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
L055449ARMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X L055449 AR Yes

Addresses

Primary practice location

889 Main St
Melbourne, AR 72556-8205

Mailing address

PO Box 967
Melbourne, AR 72556-0967
Phone (870) 368-4586

Other providers in Melbourne, AR

All providers in Melbourne, AR · Licensed Practical Nurse in Arkansas

Sources for this page

Verify at the official NPI Registry.