| Doctor Name: | LAURIE KIRKHAM |
| NPI Number: | 1194142364 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | AP07722 |
| Business Practice Address: | 5541 Highway 1 Marksville, LA - 713512650 |
| Business Phone Number: | 3182407240 |
| Business Fax Number: | 3182407118 |
| Mailing Address: | 919 Hidden Rdg, 6th Floor IRVING |
| State: | TX |
| Postal Code: | 750383813 |
| Phone Number: | 4692822711 |
| Fax Number: | 4682822609 |
| NPI Enumeration Date: | 03/25/2014 |
| NPI Last Update Date: | 07/08/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP07722 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |