Provider Demographics
NPI:1467844886
Name:JALOVEC, KRYSTAL (PA-C)
Entity Type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:
Last Name:JALOVEC
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KRYSTAL
Other - Middle Name:
Other - Last Name:HOLTCAMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:866 S HIGH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43206-1929
Mailing Address - Country:US
Mailing Address - Phone:440-567-2646
Mailing Address - Fax:
Practice Address - Street 1:70 S CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-1397
Practice Address - Country:US
Practice Address - Phone:614-890-6555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-22
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical