Provider Demographics
NPI:1174736466
Name:KIRKPATRICK, ERIN MALONE
Entity type:Individual
Prefix:MS
First Name:ERIN
Middle Name:MALONE
Last Name:KIRKPATRICK
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 1:2680 DAYTON AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-2443
Mailing Address - Country:US
Mailing Address - Phone:614-316-2603
Mailing Address - Fax:
Practice Address - Street 1:2680 DAYTON AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43202-2443
Practice Address - Country:US
Practice Address - Phone:614-316-2603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2371508Medicaid