Provider Demographics
NPI:1639113731
Name:SITTIG-RUNGE, PATRICIA ANNE (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANNE
Last Name:SITTIG-RUNGE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:ANNE
Other - Last Name:SITTIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:MADIGAN ARMY HOSPITAL
Mailing Address - Street 2:NISQUALLY FAMILY CLINIC
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98431-1100
Mailing Address - Country:US
Mailing Address - Phone:253-966-8021
Mailing Address - Fax:
Practice Address - Street 1:MADIGAN ARMY HOSPITAL
Practice Address - Street 2:NISQUALLY FAMILY CLINIC
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-1100
Practice Address - Country:US
Practice Address - Phone:253-966-8021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200150054363LF0000X
WARN00125492363LF0000X
TX625713363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
P54531Medicare UPIN
TXP54531Medicare UPIN