Provider Demographics
NPI:1972747301
Name:NTIM, RITA (STNA)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:NTIM
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3222 SUMMERHILL LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-4634
Mailing Address - Country:US
Mailing Address - Phone:614-772-1676
Mailing Address - Fax:
Practice Address - Street 1:3222 SUMMERHILL LN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-4632
Practice Address - Country:US
Practice Address - Phone:614-772-1676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-29
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400748000508376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide