Provider Demographics
NPI:1245340942
Name:KIRBY, ARIANNE MARIE (RD, LDN)
Entity type:Individual
Prefix:
First Name:ARIANNE
Middle Name:MARIE
Last Name:KIRBY
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:ARIANNE
Other - Middle Name:MARIE
Other - Last Name:COFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2503 AMBER ORCHARD CT W UNIT 301
Mailing Address - Street 2:
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113-3634
Mailing Address - Country:US
Mailing Address - Phone:410-353-0771
Mailing Address - Fax:
Practice Address - Street 1:2000 MEDICAL PKWY
Practice Address - Street 2:SUITE 600
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3742
Practice Address - Country:US
Practice Address - Phone:443-481-6699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD02390133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD331820600Medicaid
MD9795913OtherAETNA HMO
MD3715824OtherCIGNA
MDY792-0006OtherCAREFIRST
MD265665OtherJHHC PRODUCTS
MD9795913OtherAETNA PPO
MD331820600Medicaid