Provider Demographics
NPI:1437996790
Name:KIRKWOOD, CHRISTINA Y
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:Y
Last Name:KIRKWOOD
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 1:34188 EUCLID AVE APT E26
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-3357
Mailing Address - Country:US
Mailing Address - Phone:216-324-6636
Mailing Address - Fax:
Practice Address - Street 1:34188 EUCLID AVE APT E26
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-3357
Practice Address - Country:US
Practice Address - Phone:216-324-6636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH370075730701374U00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health Aide