MEDICARE: MRS. SARA KRIVANEC CD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174N00000X	Lactation Consultant (Non-RN)	ALPP-314702	VA
2	374J00000X	Doula

General Provider Information

NPI Number	:	1083930630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SARA KRIVANEC CD

Provider Business Mailing Address
First Line	:	1726 ALTAMONT AVE STE 2
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23230-4532
Country	:	US
Telephone Number	:	804-387-8847
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 ROSE AVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23222-4906
Country	:	US
Telephone Number	:	804-804-3878
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2010
Last Update Date	:	04/08/2021

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