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NPI Code Detail

MEDICARE: SONJA M WILLS NP-C

MEDICARE: SONJA M WILLS NP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerRN.315594OH
2363LF0000XFamily Nurse PractitionerAPRN.CNP.14335OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1871833483
Entity Type Code : Individual
Provider Name (Legal Business Name) : SONJA M WILLS NP-C
Provider Business Mailing Address
First Line : 2620 ELM HILL PIKE
Second Line :
City : NASHVILLE
State : TN
Zip : 37214-3108
Country : US
Telephone Number : 615-425-4241
Fax Number : 615-425-4268
Provider Business Practice Location Address
First Line : 1425 COLUMBUS AVE
Second Line :
City : LEBANON
State : OH
Zip : 45036-8258
Country : US
Telephone Number : 513-282-3010
Fax Number : 513-282-3011
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2013
Last Update Date : 04/12/2019

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