Provider Demographics
NPI:1477003887
Name:PITTS, LANA
Entity Type:Individual
Prefix:
First Name:LANA
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:PO BOX 95
Mailing Address - Street 2:
Mailing Address - City:S COFFEYVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74072-0095
Mailing Address - Country:US
Mailing Address - Phone:620-515-1228
Mailing Address - Fax:
Practice Address - Street 1:4200 SE ADAMS RD
Practice Address - Street 2:SUITE B
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-8448
Practice Address - Country:US
Practice Address - Phone:620-515-1228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator