Provider Demographics
NPI:1699940734
Name:JOLIVETTE, KRISTIN M (RN)
Entity type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:M
Last Name:JOLIVETTE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 E. LASALLE AVE
Mailing Address - Street 2:
Mailing Address - City:BARRON
Mailing Address - State:WI
Mailing Address - Zip Code:54812-1635
Mailing Address - Country:US
Mailing Address - Phone:715-637-2035
Mailing Address - Fax:
Practice Address - Street 1:1207 E. LASALLE AVE
Practice Address - Street 2:
Practice Address - City:BARRON
Practice Address - State:WI
Practice Address - Zip Code:54812-1635
Practice Address - Country:US
Practice Address - Phone:715-637-2035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI114666163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse