Provider Demographics
NPI:1285642892
Name:VITT, VERA (ARNP)
Entity Type:Individual
Prefix:MS
First Name:VERA
Middle Name:
Last Name:VITT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MT CARMEL WAY
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-7587
Mailing Address - Country:US
Mailing Address - Phone:620-231-7600
Mailing Address - Fax:620-231-7602
Practice Address - Street 1:200 E. CENTENNIAL DR.
Practice Address - Street 2:STE. 13
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762
Practice Address - Country:US
Practice Address - Phone:620-231-1068
Practice Address - Fax:620-231-2792
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS74750363L00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS042406OtherBCBS NUMBER
KS100402910BMedicaid
161685Medicare PIN
KS042406OtherBCBS NUMBER
KS100402910BMedicaid