Basic Information
Provider Information
NPI: 1609168194
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KIRKPATRICK
FirstName: MARGARET
MiddleName: G.
NamePrefix:  
NameSuffix:  
Credential: LPN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1451 DOWELL SPRINGS BLVD
Address2: SUITE 101
City: KNOXVILLE
State: TN
PostalCode: 379092450
CountryCode: US
TelephoneNumber: 8653747123
FaxNumber: 8653747129
Practice Location
Address1: 210 SIMMONS ST
Address2:  
City: MARYVILLE
State: TN
PostalCode: 378014750
CountryCode: US
TelephoneNumber: 8659709800
FaxNumber: 8653747129
Other Information
ProviderEnumerationDate: 05/03/2011
LastUpdateDate: 05/03/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
164W00000X49208TNY Nursing Service ProvidersLicensed Practical Nurse 

No ID Information.


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