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NPI Code Detail

MEDICARE: KIRBY MOIR RDN

MEDICARE: KIRBY MOIR RDN
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
1133V00000XRegistered Dietitian86048781VA

General Provider Information

NPI Number : 1386013761
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIRBY MOIR RDN
Provider Business Mailing Address
First Line : 1015 COLONIAL AVE
Second Line : APT 5
City : NORFOLK
State : VA
Zip : 23507-1727
Country : US
Telephone Number : 276-202-3298
Fax Number :
Provider Business Practice Location Address
First Line : 1577 LASKIN RD
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23451-6464
Country : US
Telephone Number : 757-422-4728
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2015
Last Update Date : 09/22/2015

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Directions to “ KIRBY MOIR RDN” Practice Location

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