Provider Demographics
NPI:1437545175
Name:KVITKO, YULIYA (RN)
Entity Type:Individual
Prefix:
First Name:YULIYA
Middle Name:
Last Name:KVITKO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:INTEGRITY
Other - Middle Name:HOME
Other - Last Name:CARE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LLC
Mailing Address - Street 1:1098 OAKDALE CT.
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-8610
Mailing Address - Country:US
Mailing Address - Phone:540-929-0201
Mailing Address - Fax:866-316-9982
Practice Address - Street 1:1098 OAKDALE CT.
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-8610
Practice Address - Country:US
Practice Address - Phone:540-929-0201
Practice Address - Fax:866-316-9982
Is Sole Proprietor?:No
Enumeration Date:2015-04-09
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0154384611172V00000X
VA0154384447172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0154384611Medicaid
VA0153484447Medicaid