Provider Demographics
NPI:1447258843
Name:WITT, HARRIET EMLY (CRNA)
Entity type:Individual
Prefix:MS
First Name:HARRIET
Middle Name:EMLY
Last Name:WITT
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:682 MARINA ISLE
Mailing Address - Street 2:
Mailing Address - City:WOODBINE
Mailing Address - State:GA
Mailing Address - Zip Code:31569-4061
Mailing Address - Country:US
Mailing Address - Phone:912-729-7786
Mailing Address - Fax:912-729-7786
Practice Address - Street 1:682 MARINA ISLE
Practice Address - Street 2:
Practice Address - City:WOODBINE
Practice Address - State:GA
Practice Address - Zip Code:31569-4061
Practice Address - Country:US
Practice Address - Phone:912-729-7786
Practice Address - Fax:912-729-7786
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-09
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN149187367500000X
AL1-044489367500000X
FL1981372367500000X
SC00064521367500000X
WV63776367500000X
TN0000146456367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered