Provider Demographics
NPI:1275914335
Name:PITT, JEAN MARIE (CNA)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:MARIE
Last Name:PITT
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8638 WALES CT
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-5826
Mailing Address - Country:US
Mailing Address - Phone:571-428-6033
Mailing Address - Fax:
Practice Address - Street 1:8638 WALES CT
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-5826
Practice Address - Country:US
Practice Address - Phone:571-428-6033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-15
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA15L23556251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health