Provider Demographics
NPI:1447920996
Name:KIRKLAND, JADE (RRT)
Entity type:Individual
Prefix:MS
First Name:JADE
Middle Name:
Last Name:KIRKLAND
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 SHANLEY ST
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14206-3325
Mailing Address - Country:US
Mailing Address - Phone:716-392-9604
Mailing Address - Fax:
Practice Address - Street 1:61 SHANLEY ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14206-3325
Practice Address - Country:US
Practice Address - Phone:716-392-9604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007868227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered