Provider Demographics
NPI:1578243770
Name:PITTMAN, SARAH ANN (NP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1428 WILLOW CREEK LN
Mailing Address - Street 2:
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126-8534
Mailing Address - Country:US
Mailing Address - Phone:612-432-7468
Mailing Address - Fax:
Practice Address - Street 1:1428 WILLOW CREEK LN
Practice Address - Street 2:
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-8534
Practice Address - Country:US
Practice Address - Phone:612-432-7468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNF06231559207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery