Provider Demographics
NPI:1497095970
Name:PITMAN, WHITNEY (APRN)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:PITMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 BISHOP LN
Mailing Address - Street 2:SUITE 1017
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218-1921
Mailing Address - Country:US
Mailing Address - Phone:502-272-5331
Mailing Address - Fax:502-272-5114
Practice Address - Street 1:529 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3229
Practice Address - Country:US
Practice Address - Phone:502-562-4370
Practice Address - Fax:502-562-4373
Is Sole Proprietor?:No
Enumeration Date:2013-02-21
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3007931363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100242600Medicaid
KY3007931OtherLICENSE
IN201150510Medicaid
KYK080711OtherMEDICARE