Provider Demographics
NPI:1750845798
Name:CASEY, SYDNEY EAGERTON (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:SYDNEY
Middle Name:EAGERTON
Last Name:CASEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MISS
Other - First Name:SYDNEY
Other - Middle Name:CAROLINE
Other - Last Name:EAGERTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:PO BOX 241587
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36124-1587
Mailing Address - Country:US
Mailing Address - Phone:334-280-1511
Mailing Address - Fax:334-280-1611
Practice Address - Street 1:273 WINTON M BLOUNT LOOP
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3507
Practice Address - Country:US
Practice Address - Phone:334-280-1500
Practice Address - Fax:334-280-1600
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-23
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-145339163W00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty