Provider Demographics
NPI:1538987177
Name:KITHCART, VICKIE
Entity type:Individual
Prefix:
First Name:VICKIE
Middle Name:
Last Name:KITHCART
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 1:1271 COUNTY ROAD 658
Mailing Address - Street 2:
Mailing Address - City:NOVA
Mailing Address - State:OH
Mailing Address - Zip Code:44859-9741
Mailing Address - Country:US
Mailing Address - Phone:419-921-6644
Mailing Address - Fax:
Practice Address - Street 1:1271 COUNTY ROAD 658
Practice Address - Street 2:
Practice Address - City:NOVA
Practice Address - State:OH
Practice Address - Zip Code:44859-9741
Practice Address - Country:US
Practice Address - Phone:419-921-6644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide