1265618755 NPI number — MRS. VICKI LYNN RITTENHOUSE BS RN

Table of content: MRS. VICKI LYNN RITTENHOUSE BS RN (NPI 1265618755)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265618755 NPI number — MRS. VICKI LYNN RITTENHOUSE BS RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RITTENHOUSE
Provider First Name:
VICKI
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
BS RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TOUCHTONE
Provider Other First Name:
VICKI
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1265618755
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/14/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1032 MORGAN DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BURLESON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76028-8132
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-201-6378
Provider Business Mailing Address Fax Number:
817-426-2924

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1032 MORGAN DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BURLESON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76028-8132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-201-6378
Provider Business Practice Location Address Fax Number:
817-426-2924
Provider Enumeration Date:
01/14/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WH1000X , with the licence number:  647642 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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