Provider Demographics
NPI:1073633780
Name:WOLFE-SIDBERRY, NANCY A (MS, MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:A
Last Name:WOLFE-SIDBERRY
Suffix:
Gender:F
Credentials:MS, MD
Other - Prefix:
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Mailing Address - Street 1:5046 THOROUGHBRED LN
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4225
Mailing Address - Country:US
Mailing Address - Phone:615-370-8080
Mailing Address - Fax:615-371-8906
Practice Address - Street 1:5046 THOROUGHBRED LN
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-4225
Practice Address - Country:US
Practice Address - Phone:615-370-8080
Practice Address - Fax:615-371-8906
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD17429207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3031534Medicare ID - Type UnspecifiedINDIVIDUAL NUMBER