Individual
CLINT B PITCHFORTH
Active
Individual
CLINT B PITCHFORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
100093
CO
367500000X
Certified Registered Nurse Anesthetist
250160
AZ
367500000X
Certified Registered Nurse Anesthetist
CRNA-01147
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053603993
—
UT
05
—
25670875
—
CO
05
—
634497
—
AZ
05
—
69837252
—
NM
01
—
NMAAA1472
MEDICARE PTAN
NM
Enumeration date
05/11/2011
Last updated
03/11/2021
Update your record
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