Provider Demographics
NPI:1821795436
Name:KIVUTI, VALERIE WAWIRA
Entity Type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:WAWIRA
Last Name:KIVUTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 ZEBULON RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-2426
Mailing Address - Country:US
Mailing Address - Phone:252-442-4024
Mailing Address - Fax:252-442-5056
Practice Address - Street 1:3101 ZEBULON RD
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-2426
Practice Address - Country:US
Practice Address - Phone:252-442-4024
Practice Address - Fax:252-442-5056
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-14
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-13286363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant