Provider Demographics
NPI:1245654946
Name:PITT, RYAN ERIC (FNP-BC)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:ERIC
Last Name:PITT
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 S TELEPHONE RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-2936
Mailing Address - Country:US
Mailing Address - Phone:405-488-0750
Mailing Address - Fax:405-488-0761
Practice Address - Street 1:901 N PORTER AVE
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-6404
Practice Address - Country:US
Practice Address - Phone:405-307-1500
Practice Address - Fax:405-307-1504
Is Sole Proprietor?:No
Enumeration Date:2014-02-15
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK85882363L00000X, 363LF0000X
TXAP132127363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily