Reva L. Kittrell, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

343959 Issued in NY

Practice address

11 W Prospect Ave
Mount Vernon, NY 10550-2017

Phone

(914) 668-8938

Fax

(914) 668-2545

NPI assigned

Oct 3, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1104540186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 N BROADWAY",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106032403",
            "telephone_number": "914-761-0600",
            "fax_number": "914-761-5367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 W PROSPECT AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502017",
            "telephone_number": "914-668-8938",
            "fax_number": "914-668-2545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITTRELL",
        "first_name": "REVA",
        "middle_name": "L.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-03",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "343959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tai Ho Kim, R.PH.
• Kindness Home Care LLC
• Simonique King
• Carmen Vinnetta Kinkead
• Theodora Kitcher, PHARMD
• Steven Scott Klein, M.D.
• Poovasit Klinoubol, DPM
• Andra Klivecka, M.A., S.L.P., C.C.C.
• Jonathan M Knee, DPM
• Knickerbocker Dialysis Inc

• Licensed Practical Nurse in Mount Vernon, NY
• Providers in Mount Vernon, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.