Provider Demographics
NPI:1245694249
Name:PRIVOTT, CIARA
Entity type:Individual
Prefix:
First Name:CIARA
Middle Name:
Last Name:PRIVOTT
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 1:820 GREENBRIER CIR
Mailing Address - Street 2:32
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-2646
Mailing Address - Country:US
Mailing Address - Phone:757-537-2273
Mailing Address - Fax:
Practice Address - Street 1:820 GREENBRIER CIR
Practice Address - Street 2:32
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-2646
Practice Address - Country:US
Practice Address - Phone:757-537-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide