Healthcare Provider Details

I. General information

NPI: 1720786189
Provider Name (Legal Business Name): SONJIA MCVAY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2023
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45388 BRITT LN
HAMMOND LA
70401-4409
US

IV. Provider business mailing address

PO BOX 378
ALBANY LA
70711-0378
US

V. Phone/Fax

Practice location:
  • Phone: 985-507-8191
  • Fax:
Mailing address:
  • Phone: 985-507-8191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number087718
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number004844711
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: