Provider Demographics
NPI:1700915998
Name:ARMSTRONG, SYLVIA
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:#1 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:SUPAI
Mailing Address - State:AZ
Mailing Address - Zip Code:86435
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:#1 MAIN STREET
Practice Address - Street 2:
Practice Address - City:SUPAI
Practice Address - State:AZ
Practice Address - Zip Code:86435
Practice Address - Country:US
Practice Address - Phone:928-448-2641
Practice Address - Fax:928-448-2312
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN069018163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1598795825Medicare ID - Type Unspecified
AZ1942318654Medicare ID - Type Unspecified