Provider Demographics
NPI:1376911149
Name:PITTS, EMILY SEIPP (NP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:SEIPP
Last Name:PITTS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:SEIPP
Other - Last Name:MARMADUKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:950 WINTER ST
Mailing Address - Street 2:SUITE 3800
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1424
Mailing Address - Country:US
Mailing Address - Phone:805-709-5094
Mailing Address - Fax:
Practice Address - Street 1:950 WINTER ST
Practice Address - Street 2:SUITE 3800
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-1424
Practice Address - Country:US
Practice Address - Phone:805-709-5094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-09
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2283677363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily