Provider Demographics
NPI:1497298996
Name:SIDBERRY, REBECCA LYNN (FNP)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:LYNN
Last Name:SIDBERRY
Suffix:
Gender:F
Credentials:FNP
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Mailing Address - Street 1:PO BOX 60352
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63160-0352
Mailing Address - Country:US
Mailing Address - Phone:314-362-3500
Mailing Address - Fax:314-230-1119
Practice Address - Street 1:1 BARNES JEWISH HOSPITAL PLZ
Practice Address - Street 2:DIV IM ENDOCRINOLOGY
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1003
Practice Address - Country:US
Practice Address - Phone:314-362-3500
Practice Address - Fax:314-230-1119
Is Sole Proprietor?:No
Enumeration Date:2016-12-01
Last Update Date:2024-04-25
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Provider Licenses
StateLicense IDTaxonomies
MO2016032502363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420038556Medicaid