Individual
MRS. COURTNEY PITTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1500 HIGHWAY 19 N, MERIDIAN, MS 39307-5335
(601) 483-5353
(601) 482-1753
Mailing address
PO BOX 2106, MERIDIAN, MS 39302-2106
(601) 703-3018
(601) 703-9283
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
879673
MS
363L00000X
Nurse Practitioner
R879673
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01487866
—
MS
05
—
2319116
—
LA
Enumeration date
10/02/2012
Last updated
10/05/2018
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