Provider Demographics
NPI:1073806758
Name:PITT, COURTNEY N (RN FNP)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:N
Last Name:PITT
Suffix:
Gender:F
Credentials:RN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 NORTH JEFFERSON
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:MO
Mailing Address - Zip Code:64633-1948
Mailing Address - Country:US
Mailing Address - Phone:660-542-3900
Mailing Address - Fax:660-542-3902
Practice Address - Street 1:1401 NORTH JEFFERSON
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:MO
Practice Address - Zip Code:64633-1948
Practice Address - Country:US
Practice Address - Phone:660-542-3900
Practice Address - Fax:660-542-3902
Is Sole Proprietor?:No
Enumeration Date:2011-05-27
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007014393363LF0000X
MO2011016062363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily