Provider Demographics
NPI:1174245930
Name:KILMAN, AUDRIANA RUTH
Entity type:Individual
Prefix:
First Name:AUDRIANA
Middle Name:RUTH
Last Name:KILMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11517 W MELVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CHENEY
Mailing Address - State:WA
Mailing Address - Zip Code:99004-9635
Mailing Address - Country:US
Mailing Address - Phone:509-998-3085
Mailing Address - Fax:
Practice Address - Street 1:11517 W MELVILLE RD
Practice Address - Street 2:
Practice Address - City:CHENEY
Practice Address - State:WA
Practice Address - Zip Code:99004-9635
Practice Address - Country:US
Practice Address - Phone:509-998-3085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide