Provider Demographics
NPI:1225856040
Name:BIBBINS, KAYLA HOLLIDAY
Entity type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:HOLLIDAY
Last Name:BIBBINS
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 1:6830 CARAVEL CT
Mailing Address - Street 2:
Mailing Address - City:BAKER
Mailing Address - State:LA
Mailing Address - Zip Code:70714-5503
Mailing Address - Country:US
Mailing Address - Phone:225-726-0224
Mailing Address - Fax:
Practice Address - Street 1:6830 CARAVEL CT
Practice Address - Street 2:
Practice Address - City:BAKER
Practice Address - State:LA
Practice Address - Zip Code:70714-5503
Practice Address - Country:US
Practice Address - Phone:225-726-0224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374700000XNursing Service Related ProvidersTechnicianGroup - Single Specialty