Provider Demographics
NPI:1730882440
Name:DOVE, KITTY
Entity type:Individual
Prefix:
First Name:KITTY
Middle Name:
Last Name:DOVE
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 1:1464 S MIDDLE RD
Mailing Address - Street 2:
Mailing Address - City:QUICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22847-1239
Mailing Address - Country:US
Mailing Address - Phone:540-325-5541
Mailing Address - Fax:
Practice Address - Street 1:1464 S MIDDLE RD
Practice Address - Street 2:
Practice Address - City:QUICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22847-1239
Practice Address - Country:US
Practice Address - Phone:540-325-5541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker