| Shelby Pitts Fnp Pllc | |
|
5640 Wasatch Dr Ste A South Ogden UT 84403-4993 | |
| (801) 920-6974 | |
| Not Available |
| Full Name | Shelby Pitts Fnp Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 5640 Wasatch Dr Ste A, South Ogden, Utah |
| Authorized Official Name and Position | Shelby A Pitts (OWNER) |
| Authorized Official Contact | 8019206974 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shelby Pitts Fnp Pllc 3054 Polk Ave Ogden UT 84403-0589 Ph: (801) 920-6974 | Shelby Pitts Fnp Pllc 5640 Wasatch Dr Ste A South Ogden UT 84403-4993 Ph: (801) 920-6974 |
| NPI Number | 1538869797 |
|---|---|
| Provider Enumeration Date | 03/07/2023 |
| Last Update Date | 02/08/2024 |
| Medicare PECOS PAC ID | 2466817853 |
|---|---|
| Medicare Enrollment ID | O20230509001267 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538869797 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Shelby A Pitts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679079784 PECOS PAC ID: 8123375581 Enrollment ID: I20180717003045 |
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