Provider Demographics
NPI:1942359724
Name:SYBRANT, MARY THERESA (NP-C)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:THERESA
Last Name:SYBRANT
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:310 CHICKORY WAY
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-2595
Mailing Address - Country:US
Mailing Address - Phone:302-738-8977
Mailing Address - Fax:877-803-5453
Practice Address - Street 1:6085 MARSHALEE DR
Practice Address - Street 2:SUITE 110 MD030-1000
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6023
Practice Address - Country:US
Practice Address - Phone:302-559-4446
Practice Address - Fax:410-379-3591
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DELB-0000188363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology