MEDICARE: MRS. SHERRY SITTIG APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	AP-06628	LA

General Provider Information

NPI Number	:	1811269673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHERRY SITTIG APRN

Provider Business Mailing Address
First Line	:	3645 S BEGLIS PKWY
Second Line	:
City	:	SULPHUR
State	:	LA
Zip	:	70665-8107
Country	:	US
Telephone Number	:	337-476-3149
Fax Number	:

Provider Business Practice Location Address
First Line	:	3645 S BEGLIS PKWY
Second Line	:
City	:	SULPHUR
State	:	LA
Zip	:	70665-8107
Country	:	US
Telephone Number	:	337-476-3149
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2012
Last Update Date	:	12/05/2016

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