Kikelomo M Labiran

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

196042 Issued in GA

Practice address

4174 Fortune PT
Atlanta, GA 30349-1387

Phone

(404) 409-8365

NPI assigned

Apr 3, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Palmgroove Enterprises LLC

  • Respite Care
  • College Park, GA
  • NPI 1174931299
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1073218871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4174 FORTUNE PT",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303491387",
            "telephone_number": "404-409-8365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4174 FORTUNE PT",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303491387",
            "telephone_number": "404-409-8365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABIRAN",
        "first_name": "KIKELOMO",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "196042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lab Test Express
• Lab-Smart
• Kelly Ann Labbe, PA
• Michelle Labbe, CCD
• John Paul Labert, PAAA
• Labladies, LLC
• Labmd Inc
• Laboratory Corporation of America Holdings
• David Laborde, MD
• Deja-Marie Leandra Laborde

• Nurse Practitioner in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.