Provider Demographics
NPI:1124858089
Name:LITCHENBERG, KATHLEEN RENEE (RN)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:RENEE
Last Name:LITCHENBERG
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 1:3670 WREN ST
Mailing Address - Street 2:
Mailing Address - City:ROBSTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78380-5920
Mailing Address - Country:US
Mailing Address - Phone:361-438-3785
Mailing Address - Fax:
Practice Address - Street 1:925 W POINT RD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78416-2128
Practice Address - Country:US
Practice Address - Phone:361-910-1827
Practice Address - Fax:956-291-9852
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX660460163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse