Basic Information
| Provider Information | |||||||||
| NPI: | 1164843850 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KRIVOY | ||||||||
| FirstName: | JULIA | ||||||||
| MiddleName: | |||||||||
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| Credential: | CRNA | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | VERTKIN | ||||||||
| OtherFirstName: | JULIA | ||||||||
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| OtherCredential: | CRNA | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2006 HOGBACK ROAD | ||||||||
| Address2: | SUITE 5A | ||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7347862317 | ||||||||
| FaxNumber: | 7347864977 | ||||||||
| Practice Location | |||||||||
| Address1: | 33155 ANNAPOLIS ST. | ||||||||
| Address2: | BEAUMONT/OAKWOOD HOSPITAL - WAYNE | ||||||||
| City: | WAYNE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48184 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7344674000 | ||||||||
| FaxNumber: | 7347862317 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/23/2013 | ||||||||
| LastUpdateDate: | 06/27/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 4704273549 | MI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.