Provider Demographics
NPI:1194279679
Name:PITMAN, ELIZABETH (APRN-CNS)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:PITMAN
Suffix:
Gender:F
Credentials:APRN-CNS
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:
Other - Last Name:PITMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5300 N INDEPENDENCE AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5556
Mailing Address - Country:US
Mailing Address - Phone:405-949-3349
Mailing Address - Fax:405-945-5467
Practice Address - Street 1:3300 NW EXPRESSWAY
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4418
Practice Address - Country:US
Practice Address - Phone:405-949-3349
Practice Address - Fax:405-945-5493
Is Sole Proprietor?:No
Enumeration Date:2016-08-12
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK99067364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist