Provider Demographics
NPI:1497094775
Name:RITCHIE, KIMBERLY DAVIS (RN)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:DAVIS
Last Name:RITCHIE
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 1:715 9TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-7169
Mailing Address - Country:US
Mailing Address - Phone:803-446-6016
Mailing Address - Fax:
Practice Address - Street 1:715 9TH ST
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-7169
Practice Address - Country:US
Practice Address - Phone:803-446-6016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC81512163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse