Provider Demographics
NPI:1588003115
Name:PARKES, KIVETTE (ND)
Entity Type:Individual
Prefix:DR
First Name:KIVETTE
Middle Name:
Last Name:PARKES
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E MOREHEAD ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-2616
Mailing Address - Country:US
Mailing Address - Phone:704-334-3761
Mailing Address - Fax:980-207-3764
Practice Address - Street 1:500 E MOREHEAD ST
Practice Address - Street 2:SUITE 102
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-2616
Practice Address - Country:US
Practice Address - Phone:704-334-3761
Practice Address - Fax:980-207-3764
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT099.0095286175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath