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General NPI Number Information
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NPI Number | 1558752071
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Entity Type | Individual
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Provider Name | MIA KILBY FNP
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Gender | Female
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Dates
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Enumeration Date | 02/05/2015
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Last Update Date | 12/10/2020
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Provider Practice Location Address
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Address Line | 850 W THOMAS ST
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City | MILLEDGEVILLE
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State | GA
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Zip | 31061-2674
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Country | US
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Telephone | 478-607-2514
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Fax | 478-607-2513
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Provider Business Mailing Address
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Address Line | PO BOX 26040
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City | MACON
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State | GA
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Zip | 31221-6040
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Country | US
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Telephone | 478-475-1299
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Fax | 866-561-8562
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN198783
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License Number State | GA
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