Healthcare Provider Details

I. General information

NPI: 1679779862
Provider Name (Legal Business Name): ALFREDA BERNADETTE RITTER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5005 N PIEDRAS ST WBAMC
EL PASO TX
79920-5001
US

IV. Provider business mailing address

5005 N. PIEDRAS STREET WBAMC
EL PASO TX
79920-5001
US

V. Phone/Fax

Practice location:
  • Phone: 915-569-1382
  • Fax:
Mailing address:
  • Phone: 915-569-1382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number179252
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: