Healthcare Provider Details

I. General information

NPI: 1083915771
Provider Name (Legal Business Name): PATRICIA L PITMAN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2010
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 SAINT LUKES CENTER DR STE 40B
CHESTERFIELD MO
63017-3509
US

IV. Provider business mailing address

PO BOX 419161
CREVE COEUR MO
63141-9161
US

V. Phone/Fax

Practice location:
  • Phone: 314-864-6266
  • Fax: 314-590-5451
Mailing address:
  • Phone: 314-523-5300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2010037215
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: