Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Siedyria Mallard

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1720751894

Siedyria Mallard is a Student in an Organized Health Care Education/Training Program in Mobile, Alabama. Practices as a sole proprietor. Licensed in Alabama.

Licensed in
AL
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

2052 Post Oak Ct
Mobile, AL 36695-7300
Phone: (256) 345-3317
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 2060 (AL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1720751894
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJuly 26, 2021
Last updated in NPPESDecember 1, 2022
Certification dateDecember 1, 2022

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