Provider Demographics
NPI:1821795436
Name:KIVUTI, VALERIE WAWIRA (PA)
Entity type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:WAWIRA
Last Name:KIVUTI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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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:2024-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-13286363A00000X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant