Provider Demographics
NPI:1871811562
Name:SANGYE, FIDELIS (CNP)
Entity type:Individual
Prefix:
First Name:FIDELIS
Middle Name:
Last Name:SANGYE
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 NW WASHINGTON BLVD
Mailing Address - Street 2:STE C
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-6381
Mailing Address - Country:US
Mailing Address - Phone:513-254-3893
Mailing Address - Fax:513-297-7904
Practice Address - Street 1:840 NW WASHINGTON BLVD
Practice Address - Street 2:STE C
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-6381
Practice Address - Country:US
Practice Address - Phone:513-737-7246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-05
Last Update Date:2019-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.021799363LP2300X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care