Provider Demographics
NPI:1740318138
Name:PITTS, JAMES RODNEY JR (RNFA)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:RODNEY
Last Name:PITTS
Suffix:JR
Gender:M
Credentials:RNFA
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 6250
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85246-6250
Mailing Address - Country:US
Mailing Address - Phone:480-768-0683
Mailing Address - Fax:480-756-1047
Practice Address - Street 1:2792 W JASPER DR
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-3908
Practice Address - Country:US
Practice Address - Phone:480-768-0683
Practice Address - Fax:480-756-1047
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN096670163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant