=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215204474
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SONYA BURKE WILLIAMS RN, MSN, FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/16/2011
-----------------------------------------------------
Last Update Date | 09/13/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2701 AMHURST BLVD # VILLAB
-----------------------------------------------------
City | NEW BERN
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28562-4294
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-723-4039
-----------------------------------------------------
Fax | 252-631-2041
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1225N NATIONAL AVE
-----------------------------------------------------
City | NEW BERN
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28560-3275
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-723-4039
-----------------------------------------------------
Fax | 910-346-1907
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 106564
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------