Provider Demographics
NPI:1740866607
Name:PITTS, NICOLE MARIE (RN)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:MARIE
Last Name:PITTS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 DUNROBIN DR
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-4232
Mailing Address - Country:US
Mailing Address - Phone:256-689-7800
Mailing Address - Fax:
Practice Address - Street 1:SEQUOIA HOSPITAL
Practice Address - Street 2:170 ALAMEDA DE LAS PULGAS
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062
Practice Address - Country:US
Practice Address - Phone:650-367-5836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA847131163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical