MEDICARE: JANETTA ANN BITTING NURSE PRACTITIONER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP109591	TX
2	363LF0000X	Family Nurse Practitioner	554347	TX
3	363L00000X	Nurse Practitioner	AP109591	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083751762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANETTA ANN BITTING NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	5012 US HWY 75 S, SUITE 300
Second Line	:	ATT: BILLING
City	:	DENISON
State	:	TX
Zip	:	75020
Country	:	US
Telephone Number	:	806-351-7540
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 SE 34TH AVE UNIT 1800
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79118-6783
Country	:	US
Telephone Number	:	806-351-7540
Fax Number	:	806-351-7546

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	08/16/2019

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