Healthcare Provider Details

I. General information

NPI: 1063326320
Provider Name (Legal Business Name): LARA INGRID SITLER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 DONOHOE DR
HUNTINGTON WV
25705-8887
US

IV. Provider business mailing address

1400 VIRGINIA ST E
CHARLESTON WV
25301-3070
US

V. Phone/Fax

Practice location:
  • Phone: 304-525-7851
  • Fax: 304-525-1073
Mailing address:
  • Phone: 304-525-7851
  • Fax: 304-525-1073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number61603
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: