Healthcare Provider Details

I. General information

NPI: 1902635105
Provider Name (Legal Business Name): BROOKLYNN SITZ CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E 10TH ST
ANNISTON AL
36207-4716
US

IV. Provider business mailing address

5224 75TH ST STE D
LUBBOCK TX
79424-2525
US

V. Phone/Fax

Practice location:
  • Phone: 256-741-6153
  • Fax:
Mailing address:
  • Phone: 806-712-1096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-164382
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number1-164382
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: