Individual provider · Type 1 NPI

Kala Ann Pozivilko, PMHNP-C

Psychiatric/Mental Health Nurse Practitioner · Grand Rapids, MI

NPI number 1669042990 Active

Practice location

790 Fuller Ave NE
Grand Rapids, MI 49503-1918

Fax (616) 336-8830

Other practice locations

  • 175 N Groesbeck Hwy, Mount Clemens, MI 48043-1562 · (616) 301-8000

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808X2021035112 (MI)
Nurse Practitioner 363L00000X4704326670 (MI)
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X4704326670 (MI)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1669042990

Kala Ann Pozivilko, PMHNP-C's National Provider Identifier is 1669042990, issued on Jun 29, 2021. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Grand Rapids, MI. The record was last updated on Feb 16, 2026.