Provider Demographics
NPI:1356585947
Name:PITTERS, CORETTA E (CRNP)
Entity type:Individual
Prefix:
First Name:CORETTA
Middle Name:E
Last Name:PITTERS
Suffix:
Gender:
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 70365
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36107-0365
Mailing Address - Country:US
Mailing Address - Phone:334-420-5038
Mailing Address - Fax:334-420-0158
Practice Address - Street 1:1845 CHERRY ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36107-2613
Practice Address - Country:US
Practice Address - Phone:334-420-5001
Practice Address - Fax:334-420-0160
Is Sole Proprietor?:No
Enumeration Date:2009-04-27
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-059430363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1-059430OtherALABAMA BOARD OF NURSING