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Individual

MRS. DEANNA M PITMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
215 E HAWAII AVE # 140, NAMPA, ID 83686-6011
(208) 514-2502
(208) 375-2217
Mailing address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 514-2500
(208) 375-2217

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
O0368
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010150852
BLUE SHIELD
ID
05
1639169626
ID
01
75085
BLUE CROSS
ID
05
807228800
ID
01
807228900
HEALTHY CONNECTIONS
ID
Enumeration date
10/21/2005
Last updated
01/25/2024
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