Provider Demographics
NPI:1750678744
Name:KIRNOS, VALERIYA KHODUSH (PA-C)
Entity Type:Individual
Prefix:MS
First Name:VALERIYA
Middle Name:KHODUSH
Last Name:KIRNOS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:VALERIYA
Other - Middle Name:KHODUSH
Other - Last Name:BRIGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:6729 FALLS OF NEUSE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-5287
Mailing Address - Country:US
Mailing Address - Phone:919-844-6344
Mailing Address - Fax:919-844-3244
Practice Address - Street 1:6729 FALLS OF NEUSE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-5287
Practice Address - Country:US
Practice Address - Phone:919-844-6344
Practice Address - Fax:919-844-3244
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-02961363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant