Individual
ELYSSA ANN PITTENGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
4020 NEW VISION DR, FORT WAYNE, IN 46845-1737
(260) 423-2567
(260) 420-2415
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 663-9008
(920) 684-1439
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28240879A
IN
363L00000X
Nurse Practitioner
Primary
71015943A
IN
Other
Enumeration date
03/21/2024
Last updated
10/09/2025
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