MEDICARE: MADISYN MAXINE SONATY

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	363LP0200X	Pediatric Nurse Practitioner	28272488A	IN

General Provider Information

NPI Number	:	1922979939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADISYN MAXINE SONATY

Provider Business Mailing Address
First Line	:	1030 HAAN DR
Second Line	:
City	:	WEST LAFAYETTE
State	:	IN
Zip	:	47906-9652
Country	:	US
Telephone Number	:	219-863-2871
Fax Number	:

Provider Business Practice Location Address
First Line	:	1030 HAAN DR
Second Line	:
City	:	WEST LAFAYETTE
State	:	IN
Zip	:	47906-9652
Country	:	US
Telephone Number	:	219-863-2871
Fax Number	:

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

Provider Enumeration Date	:	09/15/2025
Last Update Date	:	10/24/2025

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Directions to “ MADISYN MAXINE SONATY ” Practice Location

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