Provider Demographics
NPI:1225886807
Name:RITTERBACH, AMBER NICOLE (CCHW, DCCC)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:NICOLE
Last Name:RITTERBACH
Suffix:
Gender:F
Credentials:CCHW, DCCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 BOURNE AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-1916
Mailing Address - Country:US
Mailing Address - Phone:606-875-6530
Mailing Address - Fax:606-678-2708
Practice Address - Street 1:650 WHIPP AVE
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:KY
Practice Address - Zip Code:42539-3184
Practice Address - Country:US
Practice Address - Phone:606-787-6911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKCCHW12212170172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker