Individual
LARISSA MICHELE PITTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2201 LEXINGTON AVE, ASHLAND, KY 41101-2843
(606) 408-4000
(606) 408-6061
Mailing address
PO BOX 1595, ASHLAND, KY 41105-1595
(606) 408-6200
(606) 408-6612
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3003817
KY
363LF0000X
Family Nurse Practitioner
54195
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810001264
—
WV
05
—
7100079740
—
KY
Enumeration date
06/18/2006
Last updated
10/30/2018
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