1992212773 NPI number — KAREN AGAR PITTARD RN, MSN, CDCES

Table of content: KAREN AGAR PITTARD RN, MSN, CDCES (NPI 1992212773)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992212773 NPI number — KAREN AGAR PITTARD RN, MSN, CDCES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PITTARD
Provider First Name:
KAREN
Provider Middle Name:
AGAR
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN, MSN, CDCES
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992212773
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/29/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
SENTARA CAREPLEX HOSPITAL
Provider Second Line Business Mailing Address:
4000 COLISEUM DRIVE, SUITE 420
Provider Business Mailing Address City Name:
HAMPTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23666
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-827-2313
Provider Business Mailing Address Fax Number:
757-827-2173

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
SENTARA CAREPLEX HOSPITAL
Provider Second Line Business Practice Location Address:
4000 COLISEUM DRIVE, SUITE 420
Provider Business Practice Location Address City Name:
HAMPTON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23666
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-827-2313
Provider Business Practice Location Address Fax Number:
757-827-2173
Provider Enumeration Date:
01/03/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WD0400X , with the licence number:  0001070823 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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