Provider Demographics
NPI:1497375422
Name:KINARD, BRYAN JOSEPH
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:JOSEPH
Last Name:KINARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 ATLANTIC ST SE # 212
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-3702
Mailing Address - Country:US
Mailing Address - Phone:202-702-4741
Mailing Address - Fax:
Practice Address - Street 1:400 ATLANTIC ST SE # 212
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-3702
Practice Address - Country:US
Practice Address - Phone:202-702-4741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-20
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide