Provider Demographics
NPI:1386297968
Name:SITKO, MEAGAN ROSE (NP)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:ROSE
Last Name:SITKO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MEAGAN
Other - Middle Name:ROSE
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:123 E BASELINE RD STE D104
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1291
Mailing Address - Country:US
Mailing Address - Phone:480-718-0568
Mailing Address - Fax:
Practice Address - Street 1:161 E RIVULON BLVD STE 210
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-0087
Practice Address - Country:US
Practice Address - Phone:480-494-2465
Practice Address - Fax:480-534-4087
Is Sole Proprietor?:No
Enumeration Date:2019-07-22
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ227785363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily