Provider Demographics
NPI:1134539158
Name:RICHIE, KAYTLIN ELISABETH (NP)
Entity type:Individual
Prefix:
First Name:KAYTLIN
Middle Name:ELISABETH
Last Name:RICHIE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KAYTLIN
Other - Middle Name:ELISABETH
Other - Last Name:ARMSTRONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1000 E 1ST ST
Mailing Address - Street 2:STE. LL
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55805-2297
Mailing Address - Country:US
Mailing Address - Phone:218-249-4700
Mailing Address - Fax:218-722-5148
Practice Address - Street 1:1000 E 1ST ST
Practice Address - Street 2:STE. LL
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55805-2297
Practice Address - Country:US
Practice Address - Phone:218-249-4700
Practice Address - Fax:218-722-5148
Is Sole Proprietor?:No
Enumeration Date:2014-04-29
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN182619-9363L00000X
MNCNP 2872363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner