Provider Demographics
NPI:1144523416
Name:LEVITAN, KATHI SUSAN
Entity type:Individual
Prefix:MS
First Name:KATHI
Middle Name:SUSAN
Last Name:LEVITAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-5708
Mailing Address - Country:US
Mailing Address - Phone:401-390-3088
Mailing Address - Fax:
Practice Address - Street 1:U.S. EMBASSY BEIJING
Practice Address - Street 2:UNIT 7300
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96521-0627
Practice Address - Country:US
Practice Address - Phone:86108-531-4777
Practice Address - Fax:86108-531-3888
Is Sole Proprietor?:No
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMW00092367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife