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Provider Information for 1407256217



PINKIE M FITTS CRNP

Gender: FEMALE

Individual NPI: 1407256217

Calendar Last Updated: 2016-03-28

Details

Name Value
NPI 1407256217
Enumeration Date 2014-08-28
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 1040 LONGFIELD CT
MONTGOMERY, AL 36117-8055
United States

Phone: 334-288-9009 | Fax: 334-288-9497
View Map External Link
Primary Practice Address 1040 LONGFIELD CT
MONTGOMERY, AL 36117-8055
United States

Phone: 334-288-9009 | Fax: 334-288-9497
View Map External Link
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 163W00000X - Registered Nurse AL 1-092041
Other Identifiers
Issuer State Number
Other AL BOARD OF NURSING LICENSE AL 1-092041
Endpoint Information
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location