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General NPI Number Information
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NPI Number | 1962028415
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Entity Type | Individual
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Provider Name | RACHEL SITTER NP
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Gender | Female
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Dates
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Enumeration Date | 06/21/2020
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Last Update Date | 06/21/2020
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Provider Practice Location Address
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Address Line | 1905 FAIRFIELD AVE
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City | SHREVEPORT
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State | LA
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Zip | 71101-4436
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Country | US
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Telephone | 318-629-4729
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Fax |
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Provider Business Mailing Address
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Address Line | 413 BAYLYNN LN
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City | BENTON
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State | LA
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Zip | 71006-4127
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Country | US
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Telephone | 318-840-8993
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 213938
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License Number State | LA
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