Provider Demographics
NPI:1376090092
Name:PITTS, CHARINA
Entity Type:Individual
Prefix:
First Name:CHARINA
Middle Name:
Last Name:PITTS
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 1:4122 ALPHA ST APT 11
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-4750
Mailing Address - Country:US
Mailing Address - Phone:517-515-1289
Mailing Address - Fax:
Practice Address - Street 1:4122 ALPHA ST APT 11
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-4750
Practice Address - Country:US
Practice Address - Phone:517-515-1289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-10
Last Update Date:2016-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other