MEDICARE: BRITTANY ELIZABETH KILBURY CNA

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	374U00000X	Home Health Aide	CNA332637	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CNA3322637	OTHER	FL	CNA

General Provider Information

NPI Number	:	1942825963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY ELIZABETH KILBURY CNA

Provider Business Mailing Address
First Line	:	480 S LAKE AVE
Second Line	:
City	:	LAKE BUTLER
State	:	FL
Zip	:	32054-2634
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	480 S LAKE AVE
Second Line	:
City	:	LAKE BUTLER
State	:	FL
Zip	:	32054-2634
Country	:	US
Telephone Number	:	904-263-8561
Fax Number	:

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

Provider Enumeration Date	:	06/15/2020
Last Update Date	:	06/15/2020

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