Provider Demographics
NPI:1780142893
Name:TRIBLEY, BIANCA (CPNP)
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:
Last Name:TRIBLEY
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 GRESHAM DR STE 900
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-1992
Mailing Address - Country:US
Mailing Address - Phone:757-668-7473
Mailing Address - Fax:757-668-7474
Practice Address - Street 1:400 GRESHAM DR STE 900
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1992
Practice Address - Country:US
Practice Address - Phone:757-668-7473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-07
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC002629163WP0200X, 363LP0200X
VA0024180290363LP0200X, 2080P0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0008XAllopathic & Osteopathic PhysiciansPediatricsNeurodevelopmental Disabilities
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics