Provider Demographics
NPI:1548074701
Name:KIRK, LAUREN E (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:E
Last Name:KIRK
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 MAYSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:FLEMINGSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41041-8121
Mailing Address - Country:US
Mailing Address - Phone:740-776-8941
Mailing Address - Fax:
Practice Address - Street 1:730 KENTON STATION RD
Practice Address - Street 2:
Practice Address - City:MAYSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41056-9619
Practice Address - Country:US
Practice Address - Phone:740-776-8941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4034503363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health