Provider Demographics
NPI:1841842218
Name:TWITTY, VALENCEIA
Entity type:Individual
Prefix:
First Name:VALENCEIA
Middle Name:
Last Name:TWITTY
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 1:1114 E 77TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103-2008
Mailing Address - Country:US
Mailing Address - Phone:216-849-9908
Mailing Address - Fax:216-586-6607
Practice Address - Street 1:1114 E 77TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-2008
Practice Address - Country:US
Practice Address - Phone:216-849-9908
Practice Address - Fax:216-586-6607
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-15
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH164039.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse