Provider Demographics
NPI:1104641794
Name:GITTO, KRISTIE PERNELL (FNP-C)
Entity type:Individual
Prefix:
First Name:KRISTIE
Middle Name:PERNELL
Last Name:GITTO
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 FRANKLIN PLZ
Mailing Address - Street 2:
Mailing Address - City:LOUISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27549-2765
Mailing Address - Country:US
Mailing Address - Phone:919-496-4976
Mailing Address - Fax:919-496-4978
Practice Address - Street 1:315 FRANKLIN PLZ
Practice Address - Street 2:
Practice Address - City:LOUISBURG
Practice Address - State:NC
Practice Address - Zip Code:27549-2765
Practice Address - Country:US
Practice Address - Phone:919-496-4976
Practice Address - Fax:919-496-4978
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-19
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5021216363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty