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NPI Code Detail

MEDICARE: DR. JEUANNE N PITTER FNP-BC

MEDICARE: DR. JEUANNE N PITTER FNP-BC
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
1363LF0000XFamily Nurse PractitionerAPRN11010125FL

General Provider Information

NPI Number : 1215675202
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEUANNE N PITTER FNP-BC
Provider Business Mailing Address
First Line : 3829 E LAKE TER
Second Line :
City : MIRAMAR
State : FL
Zip : 33023-4943
Country : US
Telephone Number : 954-298-7967
Fax Number :
Provider Business Practice Location Address
First Line : 13305 MAHAN DR
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32309-8698
Country : US
Telephone Number : 850-893-8800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2022
Last Update Date : 05/20/2022

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