Provider Demographics
NPI:1376330506
Name:PITTMAN, BONNIE (PHLEBOTOMIST)
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 CITY PARK CIR
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39401-4934
Mailing Address - Country:US
Mailing Address - Phone:601-596-2795
Mailing Address - Fax:
Practice Address - Street 1:109 CITY PARK CIR
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-4934
Practice Address - Country:US
Practice Address - Phone:601-596-2795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Y00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health Information