Provider Demographics
NPI:1699790576
Name:SYKES, AMBER REYNOLDS (PA)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:REYNOLDS
Last Name:SYKES
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1115 BOULDERS PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4067
Mailing Address - Country:US
Mailing Address - Phone:804-560-5595
Mailing Address - Fax:804-560-9029
Practice Address - Street 1:13700 ST FRANCIS BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-3222
Practice Address - Country:US
Practice Address - Phone:804-379-2414
Practice Address - Fax:804-379-2413
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0110002330363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2366163OtherAETNA HMO
VA540885859OtherFIRST HEALTH
VA010323789Medicaid
VA540885859OtherMULTIPLAN
VA140041OtherANTHEM
VA540885859OtherFOCUS
VA289325OtherSOUTHERN HEALTH
VA10012041POtherOPTIMA HEALTH
VA540885859OtherCIGNA
VA2138218OtherUNITED HEALTHCARE
VA140041OtherANTHEM
VA2366163OtherAETNA HMO
VA011753W25Medicare PIN