Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | SP012676 | PA |
NPI | 1124426747 |
---|---|
Provider Name | Jacqueline Pitterich |
First Address | Elizabeth, PA 15037-2045 |
Second Address | Pittsburgh, PA 15224-1334 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2014 |
Last Update Date | 12/12/2014 |