Provider Demographics
NPI:1083224737
Name:ADAMS, SYDNE (LPN)
Entity Type:Individual
Prefix:
First Name:SYDNE
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:497 RICE CREEK TER NE
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-4438
Mailing Address - Country:US
Mailing Address - Phone:763-300-2293
Mailing Address - Fax:
Practice Address - Street 1:2200 1ST AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-3401
Practice Address - Country:US
Practice Address - Phone:612-871-7567
Practice Address - Fax:612-767-8749
Is Sole Proprietor?:No
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN820824164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse