Healthcare Provider Details

I. General information

NPI: 1336106095
Provider Name (Legal Business Name): KARYL LYNN FIDDYMENT RNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7501 HOSPITAL DR
SACRAMENTO CA
95823-5405
US

IV. Provider business mailing address

7501 HOSPITAL DR SUITE 204
SACRAMENTO CA
95823-5405
US

V. Phone/Fax

Practice location:
  • Phone: 916-681-2660
  • Fax: 916-681-2671
Mailing address:
  • Phone: 916-681-2660
  • Fax: 916-681-2671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number235635
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: