Provider Demographics
NPI:1790843233
Name:RITTENHOUSE, KATHRYN GRACE (FNP)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:GRACE
Last Name:RITTENHOUSE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1177 ROSE AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:CO
Mailing Address - Zip Code:80807-1756
Mailing Address - Country:US
Mailing Address - Phone:719-346-5239
Mailing Address - Fax:719-346-5268
Practice Address - Street 1:1177 ROSE AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:CO
Practice Address - Zip Code:80807-1756
Practice Address - Country:US
Practice Address - Phone:719-346-5239
Practice Address - Fax:719-346-5268
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO106704363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily