Pitchforth, Clint B

Pitchforth, Clint B is an individual health care provider with primary practice located at 1501 E 3Rd St , Delta CO 81416-2815. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Pitchforth, Clint B can be contacted via phone (970) 874-7681.

Contact Information

Primary practice address
1501 E 3Rd St Delta CO 81416-2815
Phone: (970) 874-7681
Fax: (970) 874-6400
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X CRNA-01147 New Mexico
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 250160 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 100093 Colorado

Profile Details

NPI number 1053603993
LBN Legal business name Pitchforth, Clint B
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 11th, 2011
Last updated Mar 11th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053603993 NPPES
Arizona MEDICAID 634497
Arizona MEDICAID 1053603993
Arizona MEDICAID 25670875
Arizona MEDICAID 69837252
Arizona Other NMAAA1472

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