Healthcare Provider Details

I. General information

NPI: 1316637127
Provider Name (Legal Business Name): JOHN CHRISTIAN KITTEL RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2023
Last Update Date: 05/15/2023
Certification Date: 05/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 LANGHORNE NEWTOWN RD
LANGHORNE PA
19047-1201
US

IV. Provider business mailing address

136 W MARSHALL AVE
LANGHORNE PA
19047-2149
US

V. Phone/Fax

Practice location:
  • Phone: 215-710-2000
  • Fax:
Mailing address:
  • Phone: 215-485-0989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN627682
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: