Provider Demographics
NPI:1114902277
Name:PITTILLO, DEBORAH WHITMIRE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:WHITMIRE
Last Name:PITTILLO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 27877
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0877
Mailing Address - Country:US
Mailing Address - Phone:828-694-8350
Mailing Address - Fax:828-694-7654
Practice Address - Street 1:2695 HENDERSONVILLE RD STE 200
Practice Address - Street 2:
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704-8576
Practice Address - Country:US
Practice Address - Phone:828-684-6035
Practice Address - Fax:828-654-8152
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201649363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
611186890OtherPRIVATE HEALTHCARE SAVING
611186890OtherBEECH STREET
500030491OtherRR MEDICARE
611186890OtherHUMANA TRICARE
611186890OtherCIGNA HEALTHCARE
C0039OtherMEDCOST
NCNCX355AOtherMEDICARE PTAN
0171701OtherUNITED HEALTHCARE
O12U9OtherBCBS NC
NC7000364Medicaid
SCNP0683Medicaid
611186890OtherFIRST HEALTH
611186890OtherHEALTHCARE SAVINGS
611186890OtherCRESENT
611186890OtherCIGNA HEALTHCARE
611186890OtherCRESENT