Provider Demographics
NPI:1902661523
Name:PITMAN, MARY EMMA (CRNP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:EMMA
Last Name:PITMAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9320 GAYFER ROAD EXT
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-4458
Mailing Address - Country:US
Mailing Address - Phone:251-232-2746
Mailing Address - Fax:
Practice Address - Street 1:7541 CIPRIANO CT
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-3029
Practice Address - Country:US
Practice Address - Phone:251-929-7850
Practice Address - Fax:251-929-2500
Is Sole Proprietor?:No
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-176601363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily