Provider Demographics
NPI:1033453261
Name:PITTMAN, LOUISA LEANNE (APRN)
Entity Type:Individual
Prefix:
First Name:LOUISA
Middle Name:LEANNE
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:LEANNE
Other - Middle Name:P
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:6050 CATTLERIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-6014
Mailing Address - Country:US
Mailing Address - Phone:941-365-0655
Mailing Address - Fax:
Practice Address - Street 1:6050 CATTLEMAN DR. SUITE 110
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232
Practice Address - Country:US
Practice Address - Phone:941-365-0655
Practice Address - Fax:941-893-6440
Is Sole Proprietor?:No
Enumeration Date:2012-11-10
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-75684-121363LF0000X
FL9355143363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily