Healthcare Provider Details

I. General information

NPI: 1427102268
Provider Name (Legal Business Name): SONYA KAY MOLIQUE R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6250 N 82ND ST
SCOTTSDALE AZ
85250-5609
US

IV. Provider business mailing address

7107 N VIA DE AMIGOS
SCOTTSDALE AZ
85258-3751
US

V. Phone/Fax

Practice location:
  • Phone: 480-484-7111
  • Fax: 480-484-7101
Mailing address:
  • Phone: 480-483-6090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN028039
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: