Khandra Aries Ivy
Individual provider Active NPI Phlebotomy Technician · Okolona, MS
NPI 1063199750 · NPPES record last updated Jul 3, 2023
Key facts
- NPI
- 1063199750
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Phlebotomy Technician 246RP1900X
- Practice address
- 127 Drive 156
Okolona, MS 38860-9677 - Phone
- (662) 760-3031
- NPI assigned
- Jul 3, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Phlebotomy Technician | 246RP1900X | Yes |
Addresses
Primary practice location
127 Drive 156
Okolona, MS 38860-9677
Mailing address
127 Drive 156
Okolona, MS 38860-9677
Phone (662) 760-3031
Other names
- Miss Khandra Aries Ivy
Other providers in Okolona, MS
- Heavenly Angels Community Living, Inc.
- Whitley Breanna Hill
- Hodges Adult Day Care Service Inc
- Hometown Care of North Mississippi, Inc
- Shelby Hood
- Joseph Jackson
- April Denise Johnson
- Denita Kay Lyons
- Molly Marshall
- Mississippi State Department of Health
All providers in Okolona, MS · Phlebotomy Technician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 3, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.