Healthcare Provider Details

I. General information

NPI: 1104780808
Provider Name (Legal Business Name): CAROLINE COLESON PITTMAN AANP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7185 HARBOUR TOWNE PKWY S STE 200
SUFFOLK VA
23435-3896
US

IV. Provider business mailing address

PO BOX 105
BATTERY PARK VA
23304-0105
US

V. Phone/Fax

Practice location:
  • Phone: 757-457-5100
  • Fax: 757-961-3934
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024195505
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: