Provider Demographics
NPI:1497252050
Name:PAGE, SIBYL TENILLE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:SIBYL
Middle Name:TENILLE
Last Name:PAGE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5147 N 9TH AVE STE 322
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8710
Mailing Address - Country:US
Mailing Address - Phone:850-439-5681
Mailing Address - Fax:850-439-5682
Practice Address - Street 1:5147 N 9TH AVE STE 322
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504
Practice Address - Country:US
Practice Address - Phone:850-439-5681
Practice Address - Fax:850-439-5682
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9195975363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner