Provider Demographics
NPI:1346124385
Name:BILLUPS, KYRA (STNA)
Entity type:Individual
Prefix:
First Name:KYRA
Middle Name:
Last Name:BILLUPS
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 HEFFRON DR APT 9
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-7723
Mailing Address - Country:US
Mailing Address - Phone:283-219-5150
Mailing Address - Fax:
Practice Address - Street 1:35 HEFFRON DR APT 9
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-7723
Practice Address - Country:US
Practice Address - Phone:283-219-5150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4032633376K00000X
OH401986380717376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY4032633OtherSTNA LICENSE NUMBER
OH401986380717OtherSTNA LICENSE NUMBER