Healthcare Provider Details

I. General information

NPI: 1902106107
Provider Name (Legal Business Name): SONYA JOLYN SAFFELL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2010
Last Update Date: 08/26/2021
Certification Date: 08/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 E MAIN ST STE A
JUNCTION CITY OH
43748-9701
US

IV. Provider business mailing address

506 E MAIN ST STE A
JUNCTION CITY OH
43748-9701
US

V. Phone/Fax

Practice location:
  • Phone: 740-715-3160
  • Fax: 740-715-3161
Mailing address:
  • Phone: 740-715-3160
  • Fax: 740-715-3161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11597-NP
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.11597
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: