Kaitlyn Ettinger

Primary specialty

Medical-Surgical Registered NurseTaxonomy code 163WM0705X

License

26NR17595100 Issued in NJ

Practice address

946 Bloomfield Ave
Glen Ridge, NJ 07028-1308

Phone

(973) 743-1121

NPI assigned

Feb 11, 2022

Last updated

Feb 11, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Interoperability endpoints

• Direct secure messaging: kettinger704256@ahs.direct-ci.com

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

{
    "created_epoch": "1644537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1427702075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5305 TUDOR DR",
            "city": "POMPTON PLAINS",
            "state": "NJ",
            "postal_code": "074441121",
            "telephone_number": "973-580-4453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "946 BLOOMFIELD AVE",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "070281308",
            "telephone_number": "973-743-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTINGER",
        "first_name": "KAITLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-11",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "NJ",
            "license": "26NR17595100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul L Dionne
• Dmac Vascular Lab LLC
• Ruth K Dominguez Enriquez, PA
• Gerald Mario Esposito, LCSW
• Leide Etienne
• Sara E. Every, L.C.S.W.
• Joelle Falaise
• Marlyn Fernandez, MD
• Warren Finkelstein, M.D.
• Jose C Flores, DO

• Medical-Surgical Registered Nurse in Glen Ridge, NJ
• Providers in Glen Ridge, NJ by specialty
• Medical-Surgical Registered Nurse in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.