Individual
CARRIE L KITTLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
12719 STATE ROUTE 46, BOONVILLE, NY 13309-4356
(315) 942-3069
Mailing address
3264 N MAIN ST, CONSTABLEVILLE, NY 13325-2422
(315) 297-7715
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
302658-1
NY
Other
Enumeration date
05/02/2018
Last updated
05/02/2018
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