Provider Demographics
NPI:1932974094
Name:SITMANN, AMANDA JENNIE (RN)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:JENNIE
Last Name:SITMANN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:JENNIE
Other - Last Name:WEBSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20607 NE 192ND ST
Mailing Address - Street 2:
Mailing Address - City:BRUSH PRAIRIE
Mailing Address - State:WA
Mailing Address - Zip Code:98606-8912
Mailing Address - Country:US
Mailing Address - Phone:360-836-9955
Mailing Address - Fax:
Practice Address - Street 1:20607 NE 192ND ST
Practice Address - Street 2:
Practice Address - City:BRUSH PRAIRIE
Practice Address - State:WA
Practice Address - Zip Code:98606-8912
Practice Address - Country:US
Practice Address - Phone:360-836-9955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60027749163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH1000XNursing Service ProvidersRegistered NurseHospice