Provider Demographics
NPI:1306551239
Name:SIBBLIES, KAYLA (BSN, RN, IBCLC)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:SIBBLIES
Suffix:
Gender:F
Credentials:BSN, RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4950 WESTCROFT BLVD APT 411
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20151-1554
Mailing Address - Country:US
Mailing Address - Phone:903-600-0063
Mailing Address - Fax:
Practice Address - Street 1:4950 WESTCROFT BLVD APT 411
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-1554
Practice Address - Country:US
Practice Address - Phone:903-600-0063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001316647163WM0102X
VAL-300779163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn