Provider Demographics
NPI:1205268703
Name:SITTIG, CHAD SCOTT (LPN)
Entity type:Individual
Prefix:MR
First Name:CHAD
Middle Name:SCOTT
Last Name:SITTIG
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 HONEYSUCKLE LN
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:LA
Mailing Address - Zip Code:70669-6364
Mailing Address - Country:US
Mailing Address - Phone:337-304-6418
Mailing Address - Fax:
Practice Address - Street 1:2829 4TH AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-7887
Practice Address - Country:US
Practice Address - Phone:972-391-4113
Practice Address - Fax:337-433-7938
Is Sole Proprietor?:No
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA282525164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse