Provider Demographics
NPI:1073778957
Name:SIDLE, CHRISTIAN FRANCIS (RN)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:FRANCIS
Last Name:SIDLE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 LOGANS RUN
Mailing Address - Street 2:
Mailing Address - City:DRYDEN
Mailing Address - State:NY
Mailing Address - Zip Code:13053-9781
Mailing Address - Country:US
Mailing Address - Phone:607-708-4040
Mailing Address - Fax:607-708-4040
Practice Address - Street 1:3 LOGANS RUN
Practice Address - Street 2:
Practice Address - City:DRYDEN
Practice Address - State:NY
Practice Address - Zip Code:13053-9781
Practice Address - Country:US
Practice Address - Phone:607-708-4040
Practice Address - Fax:607-708-4040
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY559077-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse