Provider Demographics
NPI:1558871772
Name:KIRVEN, MELODY YVONNE
Entity Type:Individual
Prefix:MS
First Name:MELODY
Middle Name:YVONNE
Last Name:KIRVEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 POLLOCK ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23222-2849
Mailing Address - Country:US
Mailing Address - Phone:804-274-9719
Mailing Address - Fax:804-321-7654
Practice Address - Street 1:612 POLLOCK ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23222-2849
Practice Address - Country:US
Practice Address - Phone:804-274-9719
Practice Address - Fax:804-321-7654
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-02
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy