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General NPI Number Information
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NPI Number | 1306372487
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Entity Type | Individual
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Provider Name | KATRINA T SIDNEY FNP-C
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Gender | Female
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Dates
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Enumeration Date | 05/10/2017
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 712 WILKINS ST STE E
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City | SMITHFIELD
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State | NC
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Zip | 27577-4664
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Country | US
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Telephone | 919-390-1677
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Fax | 919-238-7974
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Provider Business Mailing Address
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Address Line | 1425 S POLLOCK ST # 177
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City | SELMA
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State | NC
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Zip | 27576-3405
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Country | US
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Telephone | 919-390-1677
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Fax | 919-238-7974
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5009542
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 224521
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License Number State | NC
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