Provider Demographics
NPI:1902046212
Name:SITKO, MARSHA LYNN
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:LYNN
Last Name:SITKO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45204 W DESERT CEDARS LN
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85239-4196
Mailing Address - Country:US
Mailing Address - Phone:480-694-7501
Mailing Address - Fax:
Practice Address - Street 1:18150 N ALTERRA PKWY
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85239-4200
Practice Address - Country:US
Practice Address - Phone:520-568-5160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-26
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program