Provider Demographics
NPI:1649797945
Name:KIWEWA, WILLY MULENDA
Entity type:Individual
Prefix:MR
First Name:WILLY
Middle Name:MULENDA
Last Name:KIWEWA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10134 DAYCREST DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45246-4866
Mailing Address - Country:US
Mailing Address - Phone:513-426-0448
Mailing Address - Fax:
Practice Address - Street 1:10134 DAYCREST DR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45246-4866
Practice Address - Country:US
Practice Address - Phone:513-426-0448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2017-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide