Healthcare Provider Details

I. General information

NPI: 1407694268
Provider Name (Legal Business Name): LEILA KIRBY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2024
Last Update Date: 09/13/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13010 HESPERIA RD STE 600
VICTORVILLE CA
92395-8321
US

IV. Provider business mailing address

13010 HESPERIA RD STE 600
VICTORVILLE CA
92395-8321
US

V. Phone/Fax

Practice location:
  • Phone: 760-946-5888
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71015505A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number95040721
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: