Healthcare Provider Details

I. General information

NPI: 1265130041
Provider Name (Legal Business Name): KATHRYN EMILY SITKI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2023
Last Update Date: 02/23/2023
Certification Date: 02/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 WELDON SPRING PKWY
WELDON SPRING MO
63304-9101
US

IV. Provider business mailing address

536 EMERSON RD
SAINT LOUIS MO
63141-6801
US

V. Phone/Fax

Practice location:
  • Phone: 636-723-9306
  • Fax:
Mailing address:
  • Phone: 618-558-2360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2023006957
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: