Provider Demographics
NPI:1679294763
Name:RIZZO, KATHLEEN MARIE (BS, RN, CWOCN)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:MARIE
Last Name:RIZZO
Suffix:
Gender:F
Credentials:BS, RN, CWOCN
Other - Prefix:MRS
Other - First Name:KATIE
Other - Middle Name:MARIE
Other - Last Name:RIZZO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BS, RN, CWOCN
Mailing Address - Street 1:713 STARTING POINT CT
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-2362
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:713 STARTING POINT CT
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-2362
Practice Address - Country:US
Practice Address - Phone:912-999-7029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001248068163WC2100X, 163WX1500X, 163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163WC2100XNursing Service ProvidersRegistered NurseContinence Care
No163WX1500XNursing Service ProvidersRegistered NurseOstomy Care