MEDICARE: KIA J SISCOE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)		VA

General Provider Information

NPI Number	:	1285566570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIA J SISCOE

Provider Business Mailing Address
First Line	:	5693 TIERRA ROJA DR APT 304
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-1011
Country	:	US
Telephone Number	:	757-582-3946
Fax Number	:

Provider Business Practice Location Address
First Line	:	5693 TIERRA ROJA DR APT 304
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-1011
Country	:	US
Telephone Number	:	757-582-3946
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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Directions to “ KIA J SISCOE ” Practice Location

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