Provider Demographics
NPI:1346705035
Name:KATHERINE B. KRIVE, DO, PLLC
Entity Type:Organization
Organization Name:KATHERINE B. KRIVE, DO, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:B
Authorized Official - Last Name:KRIVE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:517-282-0771
Mailing Address - Street 1:1612 W SHIAWASSEE ST
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48915-1271
Mailing Address - Country:US
Mailing Address - Phone:517-282-0771
Mailing Address - Fax:844-395-8841
Practice Address - Street 1:801 S WAVERLY RD STE 303
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-4200
Practice Address - Country:US
Practice Address - Phone:517-282-0771
Practice Address - Fax:612-500-4648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-06
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty