Provider Demographics
NPI:1588336721
Name:QUIRK, KIMBERLEY (NBC-HWC)
Entity type:Individual
Prefix:
First Name:KIMBERLEY
Middle Name:
Last Name:QUIRK
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 LEDGESTONE CT
Mailing Address - Street 2:
Mailing Address - City:COPLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44321-3406
Mailing Address - Country:US
Mailing Address - Phone:330-612-5944
Mailing Address - Fax:
Practice Address - Street 1:238 LEDGESTONE CT
Practice Address - Street 2:
Practice Address - City:COPLEY
Practice Address - State:OH
Practice Address - Zip Code:44321-3406
Practice Address - Country:US
Practice Address - Phone:330-612-5944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date: