Individual
STEPHANIE R PITTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
3240 AVALON PKWY, CONYERS, GA 30013-6320
(770) 860-1133
(770) 860-1599
Mailing address
3240 AVALON PKWY, CONYERS, GA 30013-6320
(770) 860-1133
(770) 860-1599
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
RN156539
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128641656A
—
GA
Enumeration date
08/16/2010
Last updated
09/12/2012
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