Healthcare Provider Details

I. General information

NPI: 1972689917
Provider Name (Legal Business Name): SONJA ALBRIGHT FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 10/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 S BARRETT LN
NEVADA MO
64772-4255
US

IV. Provider business mailing address

800 S ASH ST
NEVADA MO
64772-3223
US

V. Phone/Fax

Practice location:
  • Phone: 417-448-2439
  • Fax: 417-549-6112
Mailing address:
  • Phone: 417-667-3355
  • Fax: 417-448-3796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number149431
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: