Provider Demographics
NPI:1780191015
Name:THESSING, SYDNIE (APRN)
Entity type:Individual
Prefix:
First Name:SYDNIE
Middle Name:
Last Name:THESSING
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SYDNIE
Other - Middle Name:
Other - Last Name:MOIX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2850 STONE WOOD DR
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-6746
Mailing Address - Country:US
Mailing Address - Phone:501-733-9056
Mailing Address - Fax:
Practice Address - Street 1:605 DAVE WARD DRIVE #105
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034
Practice Address - Country:US
Practice Address - Phone:501-504-6270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-09
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARATP-001239363LF0000X
ARA005443363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily