Provider Demographics
NPI:1083126569
Name:SYBOUTS, ANNAH C (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ANNAH
Middle Name:C
Last Name:SYBOUTS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 S PLATTE CLAY WAY
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:MO
Mailing Address - Zip Code:64060-8214
Mailing Address - Country:US
Mailing Address - Phone:816-628-4409
Mailing Address - Fax:
Practice Address - Street 1:305 S PLATTE CLAY WAY
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:MO
Practice Address - Zip Code:64060
Practice Address - Country:US
Practice Address - Phone:816-628-4409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-24
Last Update Date:2019-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017032436363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily