IndividualActive
Jordan Kivrak, RN, MSN
NPI 1235929480 · Nutrition Support Registered Nurse · Fenton, MO
Provider details
- NPI number
- 1235929480
- Entity type
- Individual
- Primary specialty
- Nutrition Support Registered NurseNursing Service Providers
- Credential
- RN, MSN
- Sex
- Female
- Sole proprietor
- Yes
- License
- 2014019831 (MO)
Specialties & taxonomies
Nursing Service Providers
Practice location
216 Stone View Ct
Fenton, MO 63026-5108
Phone: (573) 300-1399
Fax: (573) 300-1399
Approximate (ZIP-level) locationGet directions
Mailing address
216 Stone View Ct
Fenton, MO 63026-5108
Registry dates
- Enumerated
- 2025-05-10
- Last updated
- 2025-05-20
- Certified
- 2025-05-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.