Healthcare Provider Details

I. General information

NPI: 1508551367
Provider Name (Legal Business Name): SYDNEY ANABEL COLON APRN-FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2023
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 WELLSTAR WAY STE 204
HOLLY SPRINGS GA
30114-9086
US

IV. Provider business mailing address

1120 WELLSTAR WAY STE 204
HOLLY SPRINGS GA
30114-9086
US

V. Phone/Fax

Practice location:
  • Phone: 470-267-0110
  • Fax: 770-999-2229
Mailing address:
  • Phone: 470-267-0110
  • Fax: 770-999-2229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN288010
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: