Provider Demographics
NPI:1235208505
Name:PITTMAN, DONNA K
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:K
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 W 16TH ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460-1116
Mailing Address - Country:US
Mailing Address - Phone:330-770-5446
Mailing Address - Fax:
Practice Address - Street 1:234 W 16TH ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460-1116
Practice Address - Country:US
Practice Address - Phone:330-770-5446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide