Pittman, Stephanie R

Pittman, Stephanie R is an individual health care provider with primary practice located at 3240 Avalon Pkwy , Conyers GA 30013-6320. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Pittman, Stephanie R can be contacted via phone (770) 860-1133.

Contact Information

Primary practice address
3240 Avalon Pkwy Conyers GA 30013-6320
Phone: (770) 860-1133
Fax: (770) 860-1599
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X RN156539 Georgia

Profile Details

NPI number 1932414893
LBN Legal business name Pittman, Stephanie R
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2010
Last updated Sep 12th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932414893 NPPES
Georgia MEDICAID 128641656A

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