Provider Demographics
NPI:1982593034
Name:KIRKPATRICK, AGNES K
Entity type:Individual
Prefix:MS
First Name:AGNES
Middle Name:K
Last Name:KIRKPATRICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 38233
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-1003
Mailing Address - Country:US
Mailing Address - Phone:980-399-1704
Mailing Address - Fax:704-919-0595
Practice Address - Street 1:220 TILLERY LANE
Practice Address - Street 2:LOT 746
Practice Address - City:MT GILEAD
Practice Address - State:NC
Practice Address - Zip Code:27306
Practice Address - Country:US
Practice Address - Phone:980-399-1704
Practice Address - Fax:704-919-0595
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No372600000XNursing Service Related ProvidersAdult Companion
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No376J00000XNursing Service Related ProvidersHomemaker
No374T00000XNursing Service Related ProvidersReligious Nonmedical Nursing Personnel
No374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide