Provider Demographics
NPI: | 1518103670 |
---|---|
Name: | KIRKLAND, CINDY LOU (APRN) |
Entity type: | Individual |
Prefix: | |
First Name: | CINDY |
Middle Name: | LOU |
Last Name: | KIRKLAND |
Suffix: | |
Gender: | |
Credentials: | APRN |
Other - Prefix: | |
Other - First Name: | CINDY |
Other - Middle Name: | LOU |
Other - Last Name: | HUGHES |
Other - Suffix: | |
Other - Last Name Type: | Former Name |
Other - Credentials: | |
Mailing Address - Street 1: | 101 RIVERFRONT BLVD STE 700 |
Mailing Address - Street 2: | |
Mailing Address - City: | BRADENTON |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 34205-8823 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 941-748-2417 |
Mailing Address - Fax: | 941-748-3694 |
Practice Address - Street 1: | 101 RIVERFRONT BLVD STE 700 |
Practice Address - Street 2: | |
Practice Address - City: | BRADENTON |
Practice Address - State: | FL |
Practice Address - Zip Code: | 34205-8823 |
Practice Address - Country: | US |
Practice Address - Phone: | 941-748-2417 |
Practice Address - Fax: | 941-748-3694 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2008-12-19 |
Last Update Date: | 2025-03-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | APRN11019745 | 363LA2200X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363LA2200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
FL | APRN11019745 | Other | STATE MEDICAL LICENSE |
VA | P01136005 | Medicare PIN | |
VA | VV8218A | Medicare PIN |