Provider Demographics
NPI:1841361573
Name:PITTMAN, DEBORAH LOUISE (APN)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LOUISE
Last Name:PITTMAN
Suffix:
Gender:
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 NORMAN AVE
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-3627
Mailing Address - Country:US
Mailing Address - Phone:508-451-2557
Mailing Address - Fax:
Practice Address - Street 1:259 NORTH ST STE 1A
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3834
Practice Address - Country:US
Practice Address - Phone:508-862-3672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA123984251S00000X, 364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAMP0524098OtherDEA NUMBER