Individual
STACIE PITTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2244 EXECUTIVE DR, HAMPTON, VA 23666-2430
(757) 827-1001
Mailing address
722 MALTBY AVE, NORFOLK, VA 23504-3530
(757) 531-6485
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024182161
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
1242953
VA
Other
Enumeration date
06/21/2021
Last updated
10/31/2024
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