Provider Demographics
NPI:1801260591
Name:RITZLER, CARRIE LYNN
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:LYNN
Last Name:RITZLER
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 1:60 MEADOWBROOK CIR
Mailing Address - Street 2:APT 3
Mailing Address - City:NEW MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44442-9767
Mailing Address - Country:US
Mailing Address - Phone:330-501-2418
Mailing Address - Fax:
Practice Address - Street 1:60 MEADOWBROOK CIR
Practice Address - Street 2:APT 3
Practice Address - City:NEW MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:44442-9767
Practice Address - Country:US
Practice Address - Phone:330-501-2418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-18
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5003829OtherDODD
OH0056279Medicaid