Provider Demographics
NPI:1104655265
Name:ARDEN, SYDNI
Entity type:Individual
Prefix:
First Name:SYDNI
Middle Name:
Last Name:ARDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SYDNI
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2111 HIGHWAY 72 N
Mailing Address - Street 2:
Mailing Address - City:LOUDON
Mailing Address - State:TN
Mailing Address - Zip Code:37774-5719
Mailing Address - Country:US
Mailing Address - Phone:865-458-9938
Mailing Address - Fax:
Practice Address - Street 1:2111 HIGHWAY 72 N
Practice Address - Street 2:
Practice Address - City:LOUDON
Practice Address - State:TN
Practice Address - Zip Code:37774-5719
Practice Address - Country:US
Practice Address - Phone:865-458-9938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN48241183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist