Provider Demographics
NPI:1922310416
Name:MUDLOFF, SYBIL JILL (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:SYBIL
Middle Name:JILL
Last Name:MUDLOFF
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2645 ALBATROSS RDG
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-1270
Mailing Address - Country:US
Mailing Address - Phone:402-321-0526
Mailing Address - Fax:
Practice Address - Street 1:2645 ALBATROSS RDG
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-1270
Practice Address - Country:US
Practice Address - Phone:402-321-0526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-13
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAF171204363LW0102X
TXAP134055363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health