Provider Demographics
NPI:1811033269
Name:PITMAN, MATTHEW PETER (FNP)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:PETER
Last Name:PITMAN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1539 ANN ST
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:NC
Mailing Address - Zip Code:28516-2301
Mailing Address - Country:US
Mailing Address - Phone:252-504-3084
Mailing Address - Fax:
Practice Address - Street 1:305 BACK RD.
Practice Address - Street 2:
Practice Address - City:OCRACOKE
Practice Address - State:NC
Practice Address - Zip Code:27960-0543
Practice Address - Country:US
Practice Address - Phone:252-928-1511
Practice Address - Fax:252-928-7391
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201520363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MP0765226OtherDEA
MP0765226OtherDEA