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General NPI Number Information
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NPI Number | 1265283329
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Entity Type | Individual
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Provider Name | SYDONNEY FIELDS
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Gender | Female
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Dates
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Enumeration Date | 03/28/2024
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Last Update Date | 03/28/2024
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Provider Practice Location Address
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Address Line | 11100 BILLINGSLEY RD
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City | WALDORF
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State | MD
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Zip | 20602-3400
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Country | US
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Telephone | 202-849-5619
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Fax |
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Provider Business Mailing Address
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Address Line | 16600 BALD EAGLE SCHOOL RD
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City | BRANDYWINE
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State | MD
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Zip | 20613-8566
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Country | US
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Telephone | 214-471-6047
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 323662
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License Number State | TX
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