| Doctor Name: | JESSICA DAWN KIRK |
| NPI Number: | 1235262924 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 2002026638 |
| Business Practice Address: | 112 N Webb St Webb City, MO - 648701916 |
| Business Phone Number: | 4176730366 |
| Business Fax Number: | 4176730093 |
| Mailing Address: | 112 N Webb St, WEBB CITY |
| State: | MO |
| Postal Code: | 648701916 |
| Phone Number: | 4176730366 |
| Fax Number: | 4176730093 |
| NPI Enumeration Date: | 03/13/2007 |
| NPI Last Update Date: | 06/16/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 2002026638 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |