Provider Demographics
NPI:1477710911
Name:PITTMAN, EVELYN JOYCE (NURSE)
Entity Type:Individual
Prefix:MRS
First Name:EVELYN
Middle Name:JOYCE
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:NURSE
Other - Prefix:MISS
Other - First Name:EVELYN
Other - Middle Name:JOYCE
Other - Last Name:JENKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2518 W GREENS RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77067-3338
Mailing Address - Country:US
Mailing Address - Phone:713-419-8453
Mailing Address - Fax:
Practice Address - Street 1:2518 W GREENS RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77067-3338
Practice Address - Country:US
Practice Address - Phone:713-419-8453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89575164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse