Provider Demographics
NPI:1336106095
Name:FIDDYMENT, KARYL LYNN (RNP)
Entity Type:Individual
Prefix:
First Name:KARYL LYNN
Middle Name:
Last Name:FIDDYMENT
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7501 HOSPITAL DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-5405
Mailing Address - Country:US
Mailing Address - Phone:916-681-2660
Mailing Address - Fax:916-681-2671
Practice Address - Street 1:7501 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-5405
Practice Address - Country:US
Practice Address - Phone:916-681-2660
Practice Address - Fax:916-681-2671
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA235635363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6358OtherNP FURNISHING