Provider Demographics
NPI:1992460539
Name:GAMROTH, SYDNIE MAREE (PMHNP)
Entity type:Individual
Prefix:MRS
First Name:SYDNIE
Middle Name:MAREE
Last Name:GAMROTH
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 ELDERBERRY BLVD
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57703-5970
Mailing Address - Country:US
Mailing Address - Phone:605-355-2500
Mailing Address - Fax:605-716-1014
Practice Address - Street 1:725 N LACROSSE ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-1491
Practice Address - Country:US
Practice Address - Phone:605-355-2500
Practice Address - Fax:605-716-1014
Is Sole Proprietor?:No
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP002204363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health