Provider Demographics
NPI:1063814176
Name:KIVIAT, JOY N (FNP)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:N
Last Name:KIVIAT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JOY
Other - Middle Name:L
Other - Last Name:NEWCOMB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3326 W LINKS DR
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-2737
Mailing Address - Country:US
Mailing Address - Phone:520-425-2589
Mailing Address - Fax:
Practice Address - Street 1:10515 N ORACLE RD STE 185
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85737-9378
Practice Address - Country:US
Practice Address - Phone:520-585-5878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-19
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN157868363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily