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General NPI Number Information
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NPI Number | 1679079784
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Entity Type | Individual
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Provider Name | SHELBY ABDULLA PITTS NP-C
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Gender | Female
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Dates
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Enumeration Date | 04/05/2018
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Last Update Date | 04/20/2023
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Provider Practice Location Address
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Address Line | 852 N MAIN ST
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City | BRIGHAM CITY
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State | UT
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Zip | 84302-1452
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Country | US
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Telephone | 801-920-6974
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Fax | 877-550-0662
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Provider Business Mailing Address
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Address Line | 3054 POLK AVE
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City | OGDEN
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State | UT
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Zip | 84403-0589
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Country | US
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Telephone |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 7977558-4405
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License Number State | UT
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