Individual
DR. KRISTA CIVILETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
75 FREEDOM PKWY STE C, PITTSBORO, NC 27312-4939
(919) 545-0911
(919) 545-0096
Mailing address
2000 PERIMETER PARK DR, SUITE 200, MORRISVILLE, NC 27560-8442
(919) 563-2896
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2014-02119
NC
207Q00000X
Family Medicine Physician
OS012949
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NCP490B
MEDICARE PTAN
NC
Enumeration date
10/13/2006
Last updated
05/06/2021
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