Provider Demographics
NPI:1669959425
Name:KATEREGGA, VIVIANNE KIGGUNDU (APRN)
Entity type:Individual
Prefix:
First Name:VIVIANNE
Middle Name:KIGGUNDU
Last Name:KATEREGGA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:VIVIANNE
Other - Middle Name:KIGGUNDU
Other - Last Name:KATEREGGA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:877-856-3774
Mailing Address - Fax:
Practice Address - Street 1:13813 METRO PKWY
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-4343
Practice Address - Country:US
Practice Address - Phone:239-938-1717
Practice Address - Fax:239-985-9634
Is Sole Proprietor?:No
Enumeration Date:2018-07-25
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9256111363LF0000X
FLAPRN9256111207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily