Provider Demographics
NPI:1609570522
Name:ARRIVANT, KATIANA
Entity Type:Individual
Prefix:
First Name:KATIANA
Middle Name:
Last Name:ARRIVANT
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 1:346 CORAM AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-3108
Mailing Address - Country:US
Mailing Address - Phone:888-331-8767
Mailing Address - Fax:
Practice Address - Street 1:346 CORAM AVE FL 2
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-3108
Practice Address - Country:US
Practice Address - Phone:881-331-8767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-27
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker