Provider Demographics
NPI:1215256623
Name:GITTER, MARYANN W (CRNP)
Entity type:Individual
Prefix:
First Name:MARYANN
Middle Name:W
Last Name:GITTER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:600 HAVERFORD RD STE 103
Mailing Address - Street 2:
Mailing Address - City:HAVERFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19041-1139
Mailing Address - Country:US
Mailing Address - Phone:610-642-9609
Mailing Address - Fax:610-541-7883
Practice Address - Street 1:600 HAVERFORD RD STE 103
Practice Address - Street 2:
Practice Address - City:HAVERFORD
Practice Address - State:PA
Practice Address - Zip Code:19041-1139
Practice Address - Country:US
Practice Address - Phone:610-642-9609
Practice Address - Fax:610-642-9612
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP008123363LF0000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics