Provider Demographics
NPI:1265033229
Name:WINFIELD, KIARA TAKEILA (RRT)
Entity Type:Individual
Prefix:
First Name:KIARA
Middle Name:TAKEILA
Last Name:WINFIELD
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:KIARA
Other - Middle Name:TAKEILA
Other - Last Name:ROUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2892 SAVILLE GARDEN WAY
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23453-7035
Mailing Address - Country:US
Mailing Address - Phone:757-502-5368
Mailing Address - Fax:
Practice Address - Street 1:1309 KEMPSVILLE RD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-2205
Practice Address - Country:US
Practice Address - Phone:757-461-5001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43107227900000X
VA0117008922227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered