Provider Demographics
NPI:1821394974
Name:SEYFERT, SYDNEY DIANN (NP)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:DIANN
Last Name:SEYFERT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 S ORANGE ST
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-3833
Mailing Address - Country:US
Mailing Address - Phone:406-540-3556
Mailing Address - Fax:406-926-1049
Practice Address - Street 1:821 S ORANGE ST
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-3833
Practice Address - Country:US
Practice Address - Phone:406-540-3556
Practice Address - Fax:406-926-1049
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-08
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60202570363LP0808X
MTNUR-RN-LIC-46667363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health