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General NPI Number Information
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NPI Number | 1831440759
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Entity Type | Individual
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Provider Name | COURTNEY PITTMAN FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/02/2012
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Last Update Date | 10/05/2018
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Provider Practice Location Address
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Address Line | 1500 HIGHWAY 19 N
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City | MERIDIAN
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State | MS
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Zip | 39307-5335
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Country | US
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Telephone | 601-483-5353
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Fax | 601-482-1753
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Provider Business Mailing Address
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Address Line | PO BOX 2106
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City | MERIDIAN
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State | MS
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Zip | 39302-2106
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Country | US
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Telephone | 601-703-3018
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Fax | 601-703-9283
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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 | R879673
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 879673
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License Number State | MS
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