Provider Demographics
NPI:1740307065
Name:RITTENHOUSE, KIMBERLY BEA (LPN)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:BEA
Last Name:RITTENHOUSE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 LOWER GLEN RD
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17044-8352
Mailing Address - Country:US
Mailing Address - Phone:717-899-7279
Mailing Address - Fax:717-899-7279
Practice Address - Street 1:5 LOWER GLEN RD
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044-8352
Practice Address - Country:US
Practice Address - Phone:717-899-7279
Practice Address - Fax:717-899-7279
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN267572164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse