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General NPI Number Information
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NPI Number | 1588812812
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Entity Type | Individual
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Provider Name | KELLEY S. BITTER NP
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Gender | Female
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Dates
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Enumeration Date | 08/28/2008
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Last Update Date | 06/14/2023
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Provider Practice Location Address
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Address Line | 340 WALNUT AV
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City | WALNUT
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State | CA
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Zip | 91789
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Country | US
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Telephone | 415-403-2156
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Fax |
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Provider Business Mailing Address
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Address Line | 9761 BELL RD
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City | NEWBURY
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State | OH
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Zip | 44065-9108
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Country | US
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Telephone | 330-701-6227
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP60949881
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | NP10184
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License Number State | OH
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