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General NPI Number Information
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NPI Number | 1003408303
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Entity Type | Individual
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Provider Name | SONIA TERESA BRUNSON FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/08/2021
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 1441 N 12TH ST FL 3
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City | PHOENIX
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State | AZ
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Zip | 85006-2837
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Country | US
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Telephone | 602-521-5700
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Fax | 602-521-5701
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Provider Business Mailing Address
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Address Line | 1441 N 12TH ST FL 3
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City | PHOENIX
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State | AZ
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Zip | 85006-2837
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Country | US
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Telephone | 602-521-5700
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Fax | 602-521-5701
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number | 253653
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 253653
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License Number State | AZ
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