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General NPI Number Information
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NPI Number | 1497567978
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Entity Type | Individual
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Provider Name | SYDNIE PELLEY
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Gender | Female
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Dates
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Enumeration Date | 01/22/2025
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 300 CORRECTIONS DR
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City | NEWPORT
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State | AR
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Zip | 72112-8008
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Country | US
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Telephone | 870-523-3808
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Fax | 870-300-1090
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Provider Business Mailing Address
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Address Line | 22 COUGAR RD
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City | SULPHUR ROCK
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State | AR
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Zip | 72579-9406
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F01250457
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License Number State | AR
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