Provider Demographics
NPI:1124719737
Name:RITCHIE, KELILA
Entity type:Individual
Prefix:
First Name:KELILA
Middle Name:
Last Name:RITCHIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4850 FIRST COAST TECH PKWY APT 1206
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-0653
Mailing Address - Country:US
Mailing Address - Phone:904-232-9673
Mailing Address - Fax:
Practice Address - Street 1:4850 FIRST COAST TECH PKWY APT 1206
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-0653
Practice Address - Country:US
Practice Address - Phone:904-232-9673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula