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NPI Code Detail

MEDICARE: SYDNIE HEIDENREICH MSN, APRN, FNP-C

MEDICARE: SYDNIE HEIDENREICH MSN, APRN, 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 Practitioner12182604-3102UT

General Provider Information

NPI Number : 1205799038
Entity Type Code : Individual
Provider Name (Legal Business Name) : SYDNIE HEIDENREICH MSN, APRN, FNP-C
Provider Business Mailing Address
First Line : 1034 N 500 W
Second Line :
City : PROVO
State : UT
Zip : 84604-3337
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1034 N 500 W
Second Line :
City : PROVO
State : UT
Zip : 84604-3337
Country : US
Telephone Number : 801-507-3223
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2025
Last Update Date : 12/08/2025

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