1437545175 NPI number — YULIYA KVITKO RN

Table of content: YULIYA KVITKO RN (NPI 1437545175)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437545175 NPI number — YULIYA KVITKO RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KVITKO
Provider First Name:
YULIYA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CARE
Provider Other First Name:
INTEGRITY
Provider Other Middle Name:
HOME
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LLC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1437545175
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/01/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1098 OAKDALE CT.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARRISONBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22801-8610
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-929-0201
Provider Business Mailing Address Fax Number:
866-316-9982

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1098 OAKDALE CT.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARRISONBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22801-8610
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-929-0201
Provider Business Practice Location Address Fax Number:
866-316-9982
Provider Enumeration Date:
04/09/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 172V00000X , with the licence number:  0154384611 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 172V00000X , with the licence number: 0154384447 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0154384611 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0153484447 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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