Provider Demographics
NPI:1821530346
Name:ERVIN, KEVINA
Entity Type:Individual
Prefix:
First Name:KEVINA
Middle Name:
Last Name:ERVIN
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 1:180 POWELL ST
Mailing Address - Street 2:APT 17G
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-8140
Mailing Address - Country:US
Mailing Address - Phone:929-320-6962
Mailing Address - Fax:
Practice Address - Street 1:180 POWELL ST
Practice Address - Street 2:APT 17G
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-8140
Practice Address - Country:US
Practice Address - Phone:929-320-6962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant