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General NPI Number Information
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NPI Number | 1669385167
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Entity Type | Individual
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Provider Name | SYDNEY COLEEN TRAVIS PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/24/2026
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Last Update Date | 09/24/2026
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Provider Practice Location Address
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Address Line | 1410 4TH STREET DR NW STE 102
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City | HICKORY
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State | NC
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Zip | 28601-2573
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Country | US
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Telephone | 828-784-0195
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Fax |
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Provider Business Mailing Address
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Address Line | 909 LAFFON RD
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City | NEWTON
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State | NC
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Zip | 28658-8641
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Country | US
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Telephone | 828-639-9968
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-17111
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License Number State | NC
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