Provider Demographics
NPI:1871365544
Name:PITTS, FREEDOM UHURA (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:FREEDOM
Middle Name:UHURA
Last Name:PITTS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1139 VICTORIAN BLVD
Mailing Address - Street 2:
Mailing Address - City:FORSYTH
Mailing Address - State:GA
Mailing Address - Zip Code:31029-4796
Mailing Address - Country:US
Mailing Address - Phone:478-994-5662
Mailing Address - Fax:
Practice Address - Street 1:922 MCDONOUGH RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:GA
Practice Address - Zip Code:30233-1522
Practice Address - Country:US
Practice Address - Phone:770-775-7832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN215728163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology