Healthcare Provider Details

I. General information

NPI: 1942166079
Provider Name (Legal Business Name): SONYA NICHOLE EVERTS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2225 PORTLAND ST
ST JOHNSBURY VT
05819-8635
US

IV. Provider business mailing address

2225 PORTLAND ST
ST JOHNSBURY VT
05819-8635
US

V. Phone/Fax

Practice location:
  • Phone: 802-748-3181
  • Fax: 802-748-6267
Mailing address:
  • Phone: 802-748-3181
  • Fax: 802-748-6267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number026.0135570
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number026.0135570
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: