Provider Demographics
NPI:1306372487
Name:SIDNEY, KATRINA T (FNP-C)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:T
Last Name:SIDNEY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1425 S POLLOCK ST # 177
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:NC
Mailing Address - Zip Code:27576-3405
Mailing Address - Country:US
Mailing Address - Phone:919-390-1677
Mailing Address - Fax:919-238-7974
Practice Address - Street 1:712 WILKINS ST STE E
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-4664
Practice Address - Country:US
Practice Address - Phone:919-390-1677
Practice Address - Fax:919-238-7974
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-10
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5009542363LF0000X
NC224521363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily