Provider Demographics
NPI:1619646262
Name:GREENBERG, SYDNEY (FNP, APRN)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:FNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 E 11TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-2709
Mailing Address - Country:US
Mailing Address - Phone:512-978-8400
Mailing Address - Fax:
Practice Address - Street 1:1705 E 11TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-2709
Practice Address - Country:US
Practice Address - Phone:512-978-8400
Practice Address - Fax:512-901-9726
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024182084363LF0000X, 363LF0000X
TX1166657363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT159813OtherBOARD OF NURSING
VA0001266603OtherBOARD OF NURSING
VA0024182084OtherBOARD OF NURSIN