Provider Demographics
NPI:1487620902
Name:KITTS, PETER (FNP-C)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:KITTS
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LIBBY
Mailing Address - State:MT
Mailing Address - Zip Code:59923
Mailing Address - Country:US
Mailing Address - Phone:406-293-8711
Mailing Address - Fax:406-293-8735
Practice Address - Street 1:211 E 2ND ST
Practice Address - Street 2:
Practice Address - City:LIBBY
Practice Address - State:MT
Practice Address - Zip Code:59923
Practice Address - Country:US
Practice Address - Phone:406-293-8711
Practice Address - Fax:406-293-8735
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-24
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT17575363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
0730431OtherRURAL HEALTH MCD
MT0430797Medicaid
27382Medicare ID - Type UnspecifiedRURAL HEALTH
MT00080535Medicare ID - Type Unspecified
MT0430797Medicaid