Provider Demographics
NPI:1699363499
Name:SITAR, COURTNEY (CRNP)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:SITAR
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 KENT TOWN MARKET
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:MD
Mailing Address - Zip Code:21619-2632
Mailing Address - Country:US
Mailing Address - Phone:667-343-9501
Mailing Address - Fax:
Practice Address - Street 1:25 KENT TOWN MARKET
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:MD
Practice Address - Zip Code:21619-2632
Practice Address - Country:US
Practice Address - Phone:667-343-9501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-06
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR212856163WX0003X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient