Individual
DR. VICTORIA KIVLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D
Contact information
Practice address
2500 NORTH STATE STREET, JACKSON, MS 39216
(601) 815-6064
(601) 984-5085
Mailing address
2500 NORTH STATE STREET, JACKSON, MS 39216-4500
(601) 815-6064
(601) 984-5085
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
80755
TX
231H00000X
Audiologist
Primary
A4056
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03232225
—
MS
Enumeration date
08/18/2015
Last updated
07/23/2018
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