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General NPI Number Information
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NPI Number | 1093663874
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Entity Type | Individual
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Provider Name | CERA ALYN PITTMAN
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Gender | Female
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Dates
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Enumeration Date | 03/18/2026
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Last Update Date | 03/18/2026
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Provider Practice Location Address
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Address Line | 1019 N WABASH AVE
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City | MARION
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State | IN
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Zip | 46952-2511
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Country | US
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Telephone | 765-251-7926
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Fax |
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Provider Business Mailing Address
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Address Line | 1019 N WABASH AVE
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City | MARION
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State | IN
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Zip | 46952-2511
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Country | US
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Telephone | 765-251-7926
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WA2000X
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Taxonomy Name | Administrator Registered Nurse
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License Number | 28219970A
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License Number State | IN
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