Healthcare Provider Details

I. General information

NPI: 1760954440
Provider Name (Legal Business Name): ANITREA VICTORIA RITVALSKI RN, BSN MBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2018
Last Update Date: 12/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1255 W 15TH ST
PLANO TX
75075-7299
US

IV. Provider business mailing address

7133 HUCKLEBERRY DR
MCKINNEY TX
75070-4794
US

V. Phone/Fax

Practice location:
  • Phone: 972-673-0404
  • Fax: 469-626-9670
Mailing address:
  • Phone: 972-741-3012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number676415
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number676415
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number676415
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: