Provider Demographics
NPI:1497088058
Name:DUFF, SIBBY S (APRN)
Entity Type:Individual
Prefix:
First Name:SIBBY
Middle Name:S
Last Name:DUFF
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SIBBY
Other - Middle Name:SUEZETTE
Other - Last Name:SERRENO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 ROSE ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0001
Mailing Address - Country:US
Mailing Address - Phone:859-323-0100
Mailing Address - Fax:859-323-0100
Practice Address - Street 1:800 ROSE ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0001
Practice Address - Country:US
Practice Address - Phone:859-323-0100
Practice Address - Fax:859-323-0100
Is Sole Proprietor?:No
Enumeration Date:2009-09-15
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6034P363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal