Kittredge, John L

Kittredge, John L is an individual health care provider with primary practice located at 3740 Edison Lakes Pkwy , Mishawaka IN 46545-3474. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Kittredge, John L can be contacted via phone (574) 252-4150.

Contact Information

Primary practice address
3740 Edison Lakes Pkwy Mishawaka IN 46545-3474
Phone: (574) 252-4150
Fax: (574) 252-4159
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5601001621 Michigan

Profile Details

NPI number 1750316196
LBN Legal business name Kittredge, John L
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2006
Last updated Nov 5th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750316196 NPPES
Michigan Other 2551100140 BC/BS OF MICHIGAN

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