Provider Demographics
NPI:1154414993
Name:PITI, CHRISTY LYNN (BS, RP)
Entity type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:LYNN
Last Name:PITI
Suffix:
Gender:F
Credentials:BS, RP
Other - Prefix:MISS
Other - First Name:CHRISTY
Other - Middle Name:LYNN
Other - Last Name:BARTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:224 N PARK AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-4964
Mailing Address - Country:US
Mailing Address - Phone:402-753-2800
Mailing Address - Fax:402-753-2863
Practice Address - Street 1:224 N PARK AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-4964
Practice Address - Country:US
Practice Address - Phone:402-753-2800
Practice Address - Fax:402-753-2863
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10259183500000X
AZ9498183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist