Healthcare Provider Details

I. General information

NPI: 1699496612
Provider Name (Legal Business Name): TANCE J SONNIER DNP, APRN, FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2022
Last Update Date: 09/07/2022
Certification Date: 09/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 BARATARIA BLVD STE A
MARRERO LA
70072-3770
US

IV. Provider business mailing address

433 35TH ST
NEW ORLEANS LA
70124-1415
US

V. Phone/Fax

Practice location:
  • Phone: 504-340-6711
  • Fax:
Mailing address:
  • Phone: 225-252-8185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number227232
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: