Provider Demographics
NPI:1528012556
Name:PITTS, NANCY AVE-LALLEMANT (CRNA)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:AVE-LALLEMANT
Last Name:PITTS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:LOUISE
Other - Last Name:AVE-LALLEMANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:3100 SPRING FOREST RD
Mailing Address - Street 2:STE 130
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-2880
Mailing Address - Country:US
Mailing Address - Phone:919-882-0706
Mailing Address - Fax:919-873-9821
Practice Address - Street 1:100 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-5272
Practice Address - Country:US
Practice Address - Phone:828-681-2420
Practice Address - Fax:828-687-0729
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC250085367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAN1431Medicaid
NCP01216386OtherMEDICARE RR
NCQ38987AMedicare PIN
SCQ329747698Medicare PIN