Provider Demographics
NPI:1750091518
Name:SITES, AUDRA (RBT)
Entity type:Individual
Prefix:
First Name:AUDRA
Middle Name:
Last Name:SITES
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 NEW KENT CT
Mailing Address - Street 2:
Mailing Address - City:STEPHENS CITY
Mailing Address - State:VA
Mailing Address - Zip Code:22655-5938
Mailing Address - Country:US
Mailing Address - Phone:540-532-5449
Mailing Address - Fax:
Practice Address - Street 1:56 CHESTER ST
Practice Address - Street 2:
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-3391
Practice Address - Country:US
Practice Address - Phone:540-532-5449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician