Healthcare Provider Details
I. General information
NPI: 1801668330
Provider Name (Legal Business Name): SYDNI RHEA NOBLE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/27/2023
Last Update Date: 11/08/2023
Certification Date: 11/08/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
910 E CHURCH ST
CHERRYVILLE NC
28021-2968
US
IV. Provider business mailing address
PO BOX 744786
ATLANTA GA
30374-4786
US
V. Phone/Fax
- Phone: 704-435-5227
- Fax:
- Phone: 704-834-2450
- Fax: 704-671-5331
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | 5019079 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 5019079 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: