MEDICARE: KATELYNNE GRACE SITTON CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	041.434937	IL
2	363LF0000X	Family Nurse Practitioner	277.005264	IL

General Provider Information

NPI Number	:	1134751332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELYNNE GRACE SITTON CNP

Provider Business Mailing Address
First Line	:	321 SUSAN DR STE C
Second Line	:
City	:	NORMAL
State	:	IL
Zip	:	61761-6285
Country	:	US
Telephone Number	:	309-455-5703
Fax Number	:	309-204-5456

Provider Business Practice Location Address
First Line	:	321 SUSAN DR STE C
Second Line	:
City	:	NORMAL
State	:	IL
Zip	:	61761-6285
Country	:	US
Telephone Number	:	309-455-5703
Fax Number	:	309-204-5456

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2020
Last Update Date	:	05/21/2026

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