Healthcare Provider Details

I. General information

NPI: 1871226803
Provider Name (Legal Business Name): SONJA HEGEMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SONJA MEHRING NP

II. Dates (important events)

Enumeration Date: 07/07/2022
Last Update Date: 10/09/2023
Certification Date: 10/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 E LEIGH ST
RICHMOND VA
23298-5004
US

IV. Provider business mailing address

12101 ROBSON ST
RICHMOND VA
23233-1735
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-7999
  • Fax: 804-828-5941
Mailing address:
  • Phone: 804-364-2928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024184642
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: