Provider Demographics
NPI:1710779756
Name:KIRKMAN, ELIJAH STANLEY
Entity type:Individual
Prefix:
First Name:ELIJAH
Middle Name:STANLEY
Last Name:KIRKMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2904 E STAN SCHLUETER LP. #64
Mailing Address - Street 2:C/O: ESK PRIVATE BANK & TRUST
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:711 N 8TH ST
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541-4816
Practice Address - Country:US
Practice Address - Phone:512-630-0945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-17
Last Update Date:2025-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner