Individual provider · Type 1 NPI

Jordan Camille Kivrak, RN, MSN

Nutrition Support Registered Nurse · Fenton, MO

NPI number 1235929480 Active

Practice location

216 Stone View Ct
Fenton, MO 63026-5108

Call (573) 300-1399 Map

Fax (573) 300-1399

Specialties and licenses

TaxonomyCodeLicense
Nutrition Support Registered Nurse Primary 163WN1003X2014019831 (MO)

Nutrition Support Registered Nurse: Definition to come...

About NPI 1235929480

Jordan Camille Kivrak, RN, MSN's National Provider Identifier is 1235929480, issued on May 10, 2025. The primary taxonomy on file is Nutrition Support Registered Nurse (163WN1003X), and the practice location is in Fenton, MO. The record was last updated on May 20, 2025.