Healthcare Provider Details

I. General information

NPI: 1972418978
Provider Name (Legal Business Name): SYDNEY ANN ROBIDEAUX
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

559 CAPITOL BLVD
SAINT PAUL MN
55103-2101
US

IV. Provider business mailing address

9684 93RD AVE N
MAPLE GROVE MN
55369-4255
US

V. Phone/Fax

Practice location:
  • Phone: 877-358-3408
  • Fax:
Mailing address:
  • Phone: 763-274-9137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number14597
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: