Provider Demographics
NPI:1487002432
Name:VANOSDALE, CYDNEY (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CYDNEY
Middle Name:
Last Name:VANOSDALE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 52948
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37950-2948
Mailing Address - Country:US
Mailing Address - Phone:865-306-5700
Mailing Address - Fax:865-584-7760
Practice Address - Street 1:9330 PARK WEST BLVD STE 508
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4313
Practice Address - Country:US
Practice Address - Phone:865-694-9676
Practice Address - Fax:865-588-3742
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20069363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ062473Medicaid