Healthcare Provider Details

I. General information

NPI: 1578964037
Provider Name (Legal Business Name): SONJA LEA STICE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SONJA LEA MANGERS APRN

II. Dates (important events)

Enumeration Date: 09/15/2014
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PINE ST STE B
HAYS KS
67601-3570
US

IV. Provider business mailing address

670 J RD
STOCKTON KS
67669-8821
US

V. Phone/Fax

Practice location:
  • Phone: 785-302-1090
  • Fax: 785-588-4623
Mailing address:
  • Phone: 785-302-1090
  • Fax: 785-588-4623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number114204
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2022003048
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2022003048
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number14-120877-032
License Number StateKS
# 5
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-78895-032
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: