Most Relevant Information
Provider Data
| NPI Number: | 1003240607 |
| Provider Name: | SUSAN LEE KIRKLE ADULT PSYCH MH NP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0808X |
| Specialty: | Nurse Practitioner |
| License Number: | 150726 |
Most Important Dates
| Enumeration Date: | 08/30/2013 |
| Last Updated: | 08/30/2013 |
Provider Practice Location
724 N 22ND ST
SAINT JOSEPH
MO
645062604
Practice Location Phone/Fax
| Phone: | 8163641501 |
| Fax: | 8163646735 |
Provider Mailing Location
724 N 22ND ST
SAINT JOSEPH
MO
645062604
Provider Mailing Phone/Fax
| Phone: | 8163641501 |
| Fax: | 8163646735 |