Provider Demographics
NPI:1972890721
Name:JARVIS, NIVEA LAVINIA (NP-C)
Entity type:Individual
Prefix:
First Name:NIVEA
Middle Name:LAVINIA
Last Name:JARVIS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:NIVEA
Other - Middle Name:LAVINIA
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:2600 N LIMESTONE ST STE 250
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45503-1114
Mailing Address - Country:US
Mailing Address - Phone:937-523-8860
Mailing Address - Fax:
Practice Address - Street 1:2600 N LIMESTONE ST STE 250
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45503-1114
Practice Address - Country:US
Practice Address - Phone:937-523-8860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.021365363L00000X
KY3006943363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily