Individual
NANCY H SIDHOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
55 LAKE AVE N, BENDICT BUILDING, WORCESTER, MA 01655-0002
(508) 334-2818
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
266145
MA
363LA2100X
Acute Care Nurse Practitioner
Primary
RN266145
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110074587A
—
MA
Enumeration date
12/04/2006
Last updated
03/08/2022
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