Provider Demographics
NPI:1265041792
Name:KRIVINSKAS, JOYCE ANN (RNCARN)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:ANN
Last Name:KRIVINSKAS
Suffix:
Gender:F
Credentials:RNCARN
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:A
Other - Last Name:KRIVINSKAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RNCARN
Mailing Address - Street 1:2700 BROOKPARK RD TRLR 209
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44134-1448
Mailing Address - Country:US
Mailing Address - Phone:440-341-2688
Mailing Address - Fax:
Practice Address - Street 1:10701 EAST BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1702
Practice Address - Country:US
Practice Address - Phone:440-341-2688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-30
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN190537163WA0400X, 163WC1500X, 163WA0400X
OH190537163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)Group - Single Specialty
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Single Specialty
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant