Provider Demographics
NPI:1073979886
Name:WEBER, SYDNEY STEVENS (CRNP)
Entity Type:Individual
Prefix:MS
First Name:SYDNEY
Middle Name:STEVENS
Last Name:WEBER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1052 ROSS CLARK CIR
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-5425
Mailing Address - Country:US
Mailing Address - Phone:334-699-3600
Mailing Address - Fax:
Practice Address - Street 1:1052 ROSS CLARK CIR
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-5425
Practice Address - Country:US
Practice Address - Phone:334-699-3600
Practice Address - Fax:334-699-3601
Is Sole Proprietor?:No
Enumeration Date:2016-01-08
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-139936363L00000X
GARN283935363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner