Provider Demographics
NPI:1568288702
Name:PITTS, ANGELA J
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:J
Last Name:PITTS
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 1:3233 UNIVERSITY DR S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-6221
Mailing Address - Country:US
Mailing Address - Phone:701-232-2452
Mailing Address - Fax:701-298-3115
Practice Address - Street 1:3233 UNIVERSITY DR S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-6221
Practice Address - Country:US
Practice Address - Phone:701-232-2452
Practice Address - Fax:701-298-3115
Is Sole Proprietor?:No
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist