Provider Demographics
NPI:1598418931
Name:KRAVCHUK, EVGENIA
Entity Type:Individual
Prefix:
First Name:EVGENIA
Middle Name:
Last Name:KRAVCHUK
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 1:6290 E LEMHI CT
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83687-9177
Mailing Address - Country:US
Mailing Address - Phone:208-913-9999
Mailing Address - Fax:
Practice Address - Street 1:6290 E LEMHI CT
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83687-9177
Practice Address - Country:US
Practice Address - Phone:208-913-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter