Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 36451 | KY |
N | 111NI0900X | Internist | 36451 | KY |
Y | 207RA0201X | Internist - Allergy & Immunology | 36451 | KY |
NPI | 1770597536 |
---|---|
Provider Name | Anne Marie Pittman |
First Address | Lexington, KY 40508-2640 |
Second Address | Lexington, KY 40508-2640 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 28/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64028046 | (05) | KY |
E43239 | (02) |