Provider Demographics
NPI:1942922968
Name:BRANNOCK, SYDNEY SLATTERY (NP)
Entity type:Individual
Prefix:MRS
First Name:SYDNEY
Middle Name:SLATTERY
Last Name:BRANNOCK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SYDNEY
Other - Middle Name:
Other - Last Name:SLATTERLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5960 FAIRVIEW RD STE 500
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3113
Mailing Address - Country:US
Mailing Address - Phone:704-495-6334
Mailing Address - Fax:
Practice Address - Street 1:330 BILLINGSLEY RD STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-3096
Practice Address - Country:US
Practice Address - Phone:704-495-6334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-15
Last Update Date:2025-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5023511363LW0102X
NC338858163W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program