Provider Demographics
NPI:1437633757
Name:PEYTON-KILBOURNE, BETTY ANN
Entity Type:Individual
Prefix:MS
First Name:BETTY
Middle Name:ANN
Last Name:PEYTON-KILBOURNE
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 1:2001 ACCOKEEK RD W
Mailing Address - Street 2:
Mailing Address - City:ACCOKEEK
Mailing Address - State:MD
Mailing Address - Zip Code:20607-2301
Mailing Address - Country:US
Mailing Address - Phone:301-283-0876
Mailing Address - Fax:301-283-0058
Practice Address - Street 1:311 CONSTITUTION AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-5921
Practice Address - Country:US
Practice Address - Phone:202-547-7654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-21
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant