Provider Demographics
NPI:1518010149
Name:KITTLE, JANE OLDIGES (ARNP)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:OLDIGES
Last Name:KITTLE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 E LIBERTY ST
Mailing Address - Street 2:SUITE 1005
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1530
Mailing Address - Country:US
Mailing Address - Phone:502-589-4448
Mailing Address - Fax:502-589-1209
Practice Address - Street 1:250 E LIBERTY ST
Practice Address - Street 2:SUITE 1005
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1530
Practice Address - Country:US
Practice Address - Phone:502-589-4448
Practice Address - Fax:502-589-1209
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1066944163WR0006X
KY6161P363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000229673OtherANTHEM BCBS
000000229673OtherANTHEM BCBS