Provider Demographics
NPI:1811682834
Name:KIRBY, HAYLE ANN
Entity type:Individual
Prefix:
First Name:HAYLE
Middle Name:ANN
Last Name:KIRBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HAYLE
Other - Middle Name:ANN
Other - Last Name:KYTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7127 RAILWAY AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21222-1121
Mailing Address - Country:US
Mailing Address - Phone:410-440-5578
Mailing Address - Fax:
Practice Address - Street 1:5445 LOCH RAVEN BLVD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21239-2937
Practice Address - Country:US
Practice Address - Phone:667-888-9384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-06
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305216065225100000X
MD29654225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist