Individual provider · Type 1 NPI

Ketia Mpovila Mbiyavanga

Student in an Organized Health Care Education/Training Program · Louisville, KY

NPI number 1255205704 Active

Practice location

1733 Harold Ave
Louisville, KY 40210-2227

Call (859) 693-1407 Map

Mailing address

509 Green Valley Dr
Lexington, KY 40511-8851

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1255205704

Ketia Mpovila Mbiyavanga's National Provider Identifier is 1255205704, issued on Sep 30, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Louisville, KY. The record was last updated on Sep 30, 2025.