Provider Demographics
NPI:1295854628
Name:KITTSON, JUANITA A (RN,CHN)
Entity Type:Individual
Prefix:
First Name:JUANITA
Middle Name:A
Last Name:KITTSON
Suffix:
Gender:F
Credentials:RN,CHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 760
Mailing Address - Street 2:BLACKFEET COMMUNITY HEALTH HOSPITAL
Mailing Address - City:BROWNING
Mailing Address - State:MT
Mailing Address - Zip Code:59417
Mailing Address - Country:US
Mailing Address - Phone:406-338-6240
Mailing Address - Fax:406-338-6384
Practice Address - Street 1:HOSPITAL HILL
Practice Address - Street 2:BLACKFEET COMMUNITY HEALTH HOSPITAL
Practice Address - City:BROWNING
Practice Address - State:MT
Practice Address - Zip Code:59417
Practice Address - Country:US
Practice Address - Phone:406-338-6240
Practice Address - Fax:406-338-6384
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTRN25055163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health