Provider Demographics
NPI:1821588062
Name:PITTS, MEGAN CHEYENNE (APRN)
Entity Type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:CHEYENNE
Last Name:PITTS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 GREEN PLAIN RD
Mailing Address - Street 2:
Mailing Address - City:HAZEL
Mailing Address - State:KY
Mailing Address - Zip Code:42049-8413
Mailing Address - Country:US
Mailing Address - Phone:606-669-7451
Mailing Address - Fax:
Practice Address - Street 1:732 GREEN PLAIN RD
Practice Address - Street 2:
Practice Address - City:HAZEL
Practice Address - State:KY
Practice Address - Zip Code:42049-8413
Practice Address - Country:US
Practice Address - Phone:606-669-7451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-14
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3012233363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily