MEDICARE: SHAKIRA PITTMAN

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	F02250485	MS

General Provider Information

NPI Number	:	1598648347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAKIRA PITTMAN

Provider Business Mailing Address
First Line	:	87 FAIRWAY PL
Second Line	:
City	:	HATTIESBURG
State	:	MS
Zip	:	39402-9622
Country	:	US
Telephone Number	:	601-410-2460
Fax Number	:

Provider Business Practice Location Address
First Line	:	228 BROADWAY DR
Second Line	:
City	:	HATTIESBURG
State	:	MS
Zip	:	39401-5074
Country	:	US
Telephone Number	:	601-410-2460
Fax Number	:

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

Provider Enumeration Date	:	07/29/2025
Last Update Date	:	07/29/2025

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Directions to “ SHAKIRA PITTMAN ” Practice Location

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