Provider Demographics
NPI:1750266490
Name:RICCIARDELLI, KAITLIN (RN)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:
Last Name:RICCIARDELLI
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 1:15646 SUMMIT PLACE CIR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-4111
Mailing Address - Country:US
Mailing Address - Phone:315-534-5181
Mailing Address - Fax:
Practice Address - Street 1:15646 SUMMIT PLACE CIR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-4111
Practice Address - Country:US
Practice Address - Phone:315-534-5181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY604214-01163W00000X
FL9562427163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty