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NPI Code Detail

MEDICARE: SYDNEY ROSE JOLLIFF FNP-C

MEDICARE: SYDNEY ROSE JOLLIFF FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner71016231AIN

General Provider Information

NPI Number : 1134930027
Entity Type Code : Individual
Provider Name (Legal Business Name) : SYDNEY ROSE JOLLIFF FNP-C
Provider Business Mailing Address
First Line : 4937 WABASH AVE
Second Line :
City : TERRE HAUTE
State : IN
Zip : 47803-1447
Country : US
Telephone Number : 812-244-9359
Fax Number :
Provider Business Practice Location Address
First Line : 1332 N 7TH ST
Second Line :
City : TERRE HAUTE
State : IN
Zip : 47807-1004
Country : US
Telephone Number : 812-238-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2025
Last Update Date : 01/18/2025

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Directions to “ SYDNEY ROSE JOLLIFF FNP-C” Practice Location

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