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Individual

MISS JENNA BRIANDA PITMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
75 YELLOW CREEK RD STE 102, EVANSTON, WY 82930-5205
(307) 789-8290
(307) 789-8975
Mailing address
500 S 11TH AVE STE 400, POCATELLO, ID 83201-4880
(208) 232-7862
(208) 232-2408

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1097238
TX
363AM0700X
Medical Physician Assistant
Primary
WY-PA714
WY

Other

Enumeration date
04/21/2011
Last updated
04/16/2024
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