Provider Demographics
NPI:1396506556
Name:KIBBY, KAMIYA E
Entity type:Individual
Prefix:
First Name:KAMIYA
Middle Name:E
Last Name:KIBBY
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:PO BOX 47
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-0047
Mailing Address - Country:US
Mailing Address - Phone:614-632-0148
Mailing Address - Fax:
Practice Address - Street 1:1130 CARBONE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-2014
Practice Address - Country:US
Practice Address - Phone:614-632-0148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide