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1386297968 NPI number — MEAGAN ROSE SITKO NP

NPI Number: 1386297968
Health Care Provider/Practitioner: MEAGAN ROSE SITKO NP

Information about “1386297968” NPI (MEAGAN ROSE SITKO NP) exists in 1386297968 in HTML format HTML  |  1386297968 in plain Text format TXT  |  1386297968 in PDF (Portable Document Format) PDF  |  1386297968 in an XML format XML  formats.

NPI Number : 1386297968 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1386297968",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SITKO",
    "FirstName": "MEAGAN",
    "MiddleName": "ROSE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "NP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "ROBINSON",
    "OtherFirstName": "MEAGAN",
    "OtherMiddleName": "ROSE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "NP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "123 E BASELINE RD STE D104",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "TEMPE",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85283-1291",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "480-718-0568",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "161 E RIVULON BLVD STE 210",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GILBERT",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85297-0087",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "480-494-2465",
    "PracticeLocationAddressFaxNumber": "480-534-4087",
    "EnumerationDate": "07/22/2019",
    "LastUpdateDate": "09/16/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363LF0000X",
        "TaxonomyName": "Family Nurse Practitioner",
        "LicenseNumber": "227785",
        "LicenseNumberStateCode": "AZ",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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