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NPI Code Detail

MEDICARE: PHYLLIS R. SYKES NP-C

MEDICARE: PHYLLIS R. SYKES NP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner0024168883VA

General Provider Information

NPI Number : 1376859637
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHYLLIS R. SYKES NP-C
Provider Business Mailing Address
First Line : 11814 KING WILLIAM RD
Second Line : PO BOX 213
City : AYLETT
State : VA
Zip : 23009-4103
Country : US
Telephone Number : 804-769-3022
Fax Number : 804-769-1253
Provider Business Practice Location Address
First Line : 11814 KING WILLIAM RD
Second Line :
City : AYLETT
State : VA
Zip : 23009-4103
Country : US
Telephone Number : 804-769-3022
Fax Number : 804-769-1253
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2010
Last Update Date : 01/12/2015

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