Provider Demographics
NPI:1306221833
Name:PITCHER, CARRIE ANN
Entity type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:ANN
Last Name:PITCHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 COUNTY ROUTE 5
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:NY
Mailing Address - Zip Code:13142-2225
Mailing Address - Country:US
Mailing Address - Phone:315-418-5814
Mailing Address - Fax:
Practice Address - Street 1:55 ERINS WAY
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:NY
Practice Address - Zip Code:13167-3253
Practice Address - Country:US
Practice Address - Phone:315-935-1335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-27
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY322471164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse