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General NPI Number Information
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NPI Number | 1710695234
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Entity Type | Individual
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Provider Name | LOUIS EDWARD WITTE AGACNP-BC
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Gender | Male
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Dates
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Enumeration Date | 11/14/2022
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Last Update Date | 01/20/2023
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Provider Practice Location Address
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Address Line | 2601 E ROOSEVELT ST
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City | PHOENIX
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State | AZ
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Zip | 85008-4973
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Country | US
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Telephone | 602-344-5011
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Fax |
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Provider Business Mailing Address
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Address Line | 2929 E THOMAS RD
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City | PHOENIX
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State | AZ
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Zip | 85016-8034
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Country | US
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Telephone | 602-470-5000
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 281837
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | RN208480
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License Number State | AZ
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