Provider Demographics
NPI:1417508235
Name:DYKE, SYBIL GAIL
Entity Type:Individual
Prefix:
First Name:SYBIL
Middle Name:GAIL
Last Name:DYKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10795 E HIGH POINT DR
Mailing Address - Street 2:
Mailing Address - City:DEWEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86327-5341
Mailing Address - Country:US
Mailing Address - Phone:951-834-2002
Mailing Address - Fax:
Practice Address - Street 1:10795 E HIGH POINT DR
Practice Address - Street 2:
Practice Address - City:DEWEY
Practice Address - State:AZ
Practice Address - Zip Code:86327-5341
Practice Address - Country:US
Practice Address - Phone:951-834-2002
Practice Address - Fax:928-583-9529
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3747A0650X3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider