Provider Demographics
NPI:1134835770
Name:WITTER, CLAUDINE LATOYA (NP)
Entity type:Individual
Prefix:
First Name:CLAUDINE
Middle Name:LATOYA
Last Name:WITTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CLAUDINE WITTER
Mailing Address - Street 2:418 HAVENSTONE LANE
Mailing Address - City:LA MARQUE
Mailing Address - State:TX
Mailing Address - Zip Code:77568-2463
Mailing Address - Country:US
Mailing Address - Phone:409-750-0417
Mailing Address - Fax:
Practice Address - Street 1:3717 HIGHWAY 3 STE A1
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-8024
Practice Address - Country:US
Practice Address - Phone:409-750-0417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-26
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1066234163WM0705X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical