Provider Demographics
NPI:1114992575
Name:SITTON, DEBORAH C (ANP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:C
Last Name:SITTON
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 840698
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-6098
Mailing Address - Country:US
Mailing Address - Phone:903-324-6450
Mailing Address - Fax:
Practice Address - Street 1:1302 N PACIFIC ST
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:TX
Practice Address - Zip Code:75773-1022
Practice Address - Country:US
Practice Address - Phone:903-569-5383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX541929363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX202067902Medicaid
TX202067901Medicaid
TX81N802OtherBCBS
TXTIN PLUS 043OtherTRICARE
TX202067902Medicaid
TXP00756303Medicare PIN
TX202067901Medicaid
S61007Medicare UPIN