Provider Demographics
NPI:1659183150
Name:WALDEN, SYDNI (FNP-C)
Entity type:Individual
Prefix:
First Name:SYDNI
Middle Name:
Last Name:WALDEN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 CROOKED CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40744-8490
Mailing Address - Country:US
Mailing Address - Phone:606-521-6108
Mailing Address - Fax:
Practice Address - Street 1:14659 N US HIGHWAY 25 E STE 16
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-5180
Practice Address - Country:US
Practice Address - Phone:606-280-7070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4034158363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily