Provider Demographics
NPI:1497738181
Name:PITTMAN, JOYCE ANN (NP CWOCN)
Entity Type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:ANN
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:NP CWOCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 SENATE BLVD
Mailing Address - Street 2:B250
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-1367
Mailing Address - Country:US
Mailing Address - Phone:317-962-8505
Mailing Address - Fax:317-962-9762
Practice Address - Street 1:1701 SENATE BLVD
Practice Address - Street 2:B250
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46206-1367
Practice Address - Country:US
Practice Address - Phone:317-962-8505
Practice Address - Fax:317-962-9762
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001578A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200451400AMedicaid
P94664Medicare UPIN
191350IMedicare ID - Type Unspecified