Healthcare Provider Details

I. General information

NPI: 1427350446
Provider Name (Legal Business Name): MICHELLE MCNEAL SONNIER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2010
Last Update Date: 03/04/2021
Certification Date: 03/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

376 MAIN ST
CANKTON LA
70584-5920
US

IV. Provider business mailing address

376 MAIN ST
CANKTON LA
70584-5920
US

V. Phone/Fax

Practice location:
  • Phone: 337-668-4141
  • Fax:
Mailing address:
  • Phone: 337-668-4141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP06240
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: