Provider Demographics
NPI:1023682812
Name:CALLAWAY, KITT ELIZABETH (RN)
Entity type:Individual
Prefix:
First Name:KITT
Middle Name:ELIZABETH
Last Name:CALLAWAY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 GALLIGAR ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:NE
Mailing Address - Zip Code:69022-3633
Mailing Address - Country:US
Mailing Address - Phone:785-543-4943
Mailing Address - Fax:
Practice Address - Street 1:1320 GALLIGAR ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:NE
Practice Address - Zip Code:69022-3633
Practice Address - Country:US
Practice Address - Phone:785-543-4943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE81889163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse