Provider Demographics
NPI:1437426061
Name:KITTS, AMY NICOLE (CNA)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:NICOLE
Last Name:KITTS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4335 MAYNARDVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:MAYNARDVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37807-3623
Mailing Address - Country:US
Mailing Address - Phone:865-992-3867
Mailing Address - Fax:
Practice Address - Street 1:4335 MAYNARDVILLE HWY
Practice Address - Street 2:
Practice Address - City:MAYNARDVILLE
Practice Address - State:TN
Practice Address - Zip Code:37807-3623
Practice Address - Country:US
Practice Address - Phone:865-992-3867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00147567376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide