Provider Demographics
NPI:1699121756
Name:NITTE, CAROL (RN)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:NITTE
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 1:5513 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:REMSEN
Mailing Address - State:NY
Mailing Address - Zip Code:13438-4293
Mailing Address - Country:US
Mailing Address - Phone:315-525-7192
Mailing Address - Fax:
Practice Address - Street 1:5513 LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:REMSEN
Practice Address - State:NY
Practice Address - Zip Code:13438-4293
Practice Address - Country:US
Practice Address - Phone:315-525-7192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-09
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY331020390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program