Provider Demographics
NPI:1972155893
Name:KILBY, TINA
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:KILBY
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 1:430 DELAWARE AVE APT 316
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23508-2847
Mailing Address - Country:US
Mailing Address - Phone:757-773-7947
Mailing Address - Fax:
Practice Address - Street 1:430 DELAWARE AVE APT 316
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23508-2847
Practice Address - Country:US
Practice Address - Phone:757-773-7947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion