Provider Demographics
NPI:1659623775
Name:PITTS, TEKIMA RICHAUN (APRN-CNP)
Entity Type:Individual
Prefix:MRS
First Name:TEKIMA
Middle Name:RICHAUN
Last Name:PITTS
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:MRS
Other - First Name:TEKIMA
Other - Middle Name:RICHAUN
Other - Last Name:COLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN-CNP
Mailing Address - Street 1:10128 MILL GRINDER LN
Mailing Address - Street 2:
Mailing Address - City:MABELVALE
Mailing Address - State:AR
Mailing Address - Zip Code:72103-4034
Mailing Address - Country:US
Mailing Address - Phone:501-257-2846
Mailing Address - Fax:
Practice Address - Street 1:2200 FORT ROOTS DR UNIT 3L
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72114-1709
Practice Address - Country:US
Practice Address - Phone:501-257-2846
Practice Address - Fax:501-257-2835
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-12
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR218888363LP0808X
ARR89336163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse