Individual
STEPHANIE LYNN SYDNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
12502 WILLOWBROOK RD, CUMBERLAND, MD 21502-6491
(240) 964-8724
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002414A
IN
363A00000X
Physician Assistant
C04552
MD
363A00000X
Physician Assistant
PA.0008276
CO
363A00000X
Physician Assistant
PA9116262
FL
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
0110003700
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300011151
—
IN
05
—
7100369110
—
KY
Enumeration date
10/30/2011
Last updated
11/21/2023
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