Provider Demographics
NPI:1639712151
Name:PITTS, KRISTIN (FNP-C)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:PITTS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 W BOGGS ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30648-2321
Mailing Address - Country:US
Mailing Address - Phone:706-743-0006
Mailing Address - Fax:706-740-6073
Practice Address - Street 1:219 W BOGGS ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:GA
Practice Address - Zip Code:30648-2321
Practice Address - Country:US
Practice Address - Phone:706-743-0006
Practice Address - Fax:706-740-6073
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-28
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN264183163WG0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice