MEDICARE: SONYA JOLYN SAFFELL FNP

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
1	363L00000X	Nurse Practitioner	11597-NP	OH
2	363LF0000X	Family Nurse Practitioner	APRN.CNP.11597	OH

Other Identifiers

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

General Provider Information

NPI Number	:	1902106107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONYA JOLYN SAFFELL FNP

Provider Business Mailing Address
First Line	:	506 E MAIN ST STE A
Second Line	:
City	:	JUNCTION CITY
State	:	OH
Zip	:	43748-9701
Country	:	US
Telephone Number	:	740-715-3160
Fax Number	:	740-715-3161

Provider Business Practice Location Address
First Line	:	506 E MAIN ST STE A
Second Line	:
City	:	JUNCTION CITY
State	:	OH
Zip	:	43748-9701
Country	:	US
Telephone Number	:	740-715-3160
Fax Number	:	740-715-3161

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2010
Last Update Date	:	08/26/2021

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