Provider Demographics
NPI:1609135391
Name:KITT, ERICA A (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:A
Last Name:KITT
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 NE TRENT AVE
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IA
Mailing Address - Zip Code:50073-8124
Mailing Address - Country:US
Mailing Address - Phone:641-521-8050
Mailing Address - Fax:
Practice Address - Street 1:411 LAUREL ST
Practice Address - Street 2:MERCY MEDICAL PLAZA, SUITE 3170
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314
Practice Address - Country:US
Practice Address - Phone:515-283-0463
Practice Address - Fax:515-283-0794
Is Sole Proprietor?:No
Enumeration Date:2012-05-15
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAD106729367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered