Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35.120606 | OH |
N | 2080P0204X | Pediatric Emergency Doctor | 35.120606 | OH |
Y | 2080P0214X | Pediatric Pulmonologist | 35.120606 | OH |
NPI | 1164721601 |
---|---|
Provider Name | Katelyn Elizabeth Krivchenia |
First Address | Columbus, OH 43205-2664 |
Second Address | Columbus, OH 43205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2011 |
Last Update Date | 08/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0207373 | (05) | OH |