Provider Demographics
NPI:1144653841
Name:CRETINI, RICHARD PAUL (RN)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:PAUL
Last Name:CRETINI
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4261 KIRBY AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45223-2030
Mailing Address - Country:US
Mailing Address - Phone:504-756-5751
Mailing Address - Fax:
Practice Address - Street 1:4261 KIRBY AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45223-2030
Practice Address - Country:US
Practice Address - Phone:504-756-5751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-16
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN111759163W00000X
OH394194163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse