Provider Demographics
NPI:1881472363
Name:NGETICH, KENETH KIBET (CNP)
Entity type:Individual
Prefix:
First Name:KENETH
Middle Name:KIBET
Last Name:NGETICH
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 POE AVE
Mailing Address - Street 2:
Mailing Address - City:LITHOPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:43136-9777
Mailing Address - Country:US
Mailing Address - Phone:301-825-2795
Mailing Address - Fax:
Practice Address - Street 1:205 POE AVE
Practice Address - Street 2:
Practice Address - City:LITHOPOLIS
Practice Address - State:OH
Practice Address - Zip Code:43136-9777
Practice Address - Country:US
Practice Address - Phone:301-825-2795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0033764363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily