Basic Information
Provider Information
NPI: 1811473135
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RITCHIE
FirstName: KIRSTIN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 CONZ ST # 2
Address2:  
City: NORTHAMPTON
State: MA
PostalCode: 010603831
CountryCode: US
TelephoneNumber: 6073518474
FaxNumber:  
Practice Location
Address1: 417 LIBERTY ST
Address2:  
City: SPRINGFIELD
State: MA
PostalCode: 011043736
CountryCode: US
TelephoneNumber: 4137470705
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/19/2018
LastUpdateDate: 07/19/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0808XRN2324036MAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


Home