Provider Demographics
NPI:1083930630
Name:KRIVANEC, SARA (CD)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:
Last Name:KRIVANEC
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1726 ALTAMONT AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-4532
Mailing Address - Country:US
Mailing Address - Phone:804-387-8847
Mailing Address - Fax:
Practice Address - Street 1:2001 ROSE AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23222-4906
Practice Address - Country:US
Practice Address - Phone:804-804-3878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-07
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAALPP-314702174N00000X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoula
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty