Provider Demographics
NPI:1316146251
Name:PITTS, DANIELLE JO (STNA)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:JO
Last Name:PITTS
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:01413 ARNOLD RD
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:OH
Mailing Address - Zip Code:45885-9007
Mailing Address - Country:US
Mailing Address - Phone:419-303-5141
Mailing Address - Fax:419-394-0901
Practice Address - Street 1:01413 ARNOLD RD
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:OH
Practice Address - Zip Code:45885-9007
Practice Address - Country:US
Practice Address - Phone:419-303-5141
Practice Address - Fax:419-394-0901
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSH783125376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide