Active NPI
Jenniferlyn Kryvicky, C.N.
- Nutritionist
- Berkley, MI
National Provider Identifier
1477099695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- NA
- Practice address
- 2446 Princeton Rd
Berkley, MI 48072-3908 - Phone
- (248) 895-3405
- NPI assigned
- Jan 11, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | NA | MI | Primary |
Addresses
Primary practice location
2446 Princeton Rd
Berkley, MI 48072-3908
Mailing address
2446 Princeton Rd
Berkley, MI 48072-3908
Phone (248) 895-3405
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484092800000",
"number": "1477099695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2446 PRINCETON RD",
"city": "BERKLEY",
"state": "MI",
"postal_code": "480723908",
"telephone_number": "248-895-3405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2446 PRINCETON RD",
"city": "BERKLEY",
"state": "MI",
"postal_code": "480723908",
"telephone_number": "248-895-3405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRYVICKY",
"first_name": "JENNIFERLYN",
"name_prefix": "Mrs.",
"credential": "C.N.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-01-11",
"last_updated": "2017-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "MI",
"license": "NA",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berkley, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.