Provider Demographics
NPI:1659606861
Name:MCKITTRICK, DONNA MARIE (RT(R)(MR))
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:MARIE
Last Name:MCKITTRICK
Suffix:
Gender:F
Credentials:RT(R)(MR)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:RR 1 BOX 27
Mailing Address - Street 2:
Mailing Address - City:HERRICK
Mailing Address - State:IL
Mailing Address - Zip Code:62431-9404
Mailing Address - Country:US
Mailing Address - Phone:618-292-2671
Mailing Address - Fax:
Practice Address - Street 1:RR 1 BOX 27
Practice Address - Street 2:
Practice Address - City:HERRICK
Practice Address - State:IL
Practice Address - Zip Code:62431-9404
Practice Address - Country:US
Practice Address - Phone:618-292-2671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance Imaging