MEDICARE: TRINA LINETTE RITTER RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH1000X	Hospice Registered Nurse	28208968A	IN

General Provider Information

NPI Number	:	1770300238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRINA LINETTE RITTER RN

Provider Business Mailing Address
First Line	:	4025 ROAMIN DR
Second Line	:
City	:	GREENWOOD
State	:	IN
Zip	:	46142-8416
Country	:	US
Telephone Number	:	317-407-1951
Fax Number	:

Provider Business Practice Location Address
First Line	:	950 N MERIDIAN ST STE 700
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46204-1236
Country	:	US
Telephone Number	:	317-407-1951
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2024
Last Update Date	:	09/25/2024

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