=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245743913
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SONYA RENEE THOMAS APRN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/15/2017
-----------------------------------------------------
Last Update Date | 12/30/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 401 11TH ST NE
-----------------------------------------------------
City | SPRINGHILL
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71075-4503
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-539-1701
-----------------------------------------------------
Fax | 318-539-1725
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1982 OLD PLAIN DEALING RD
-----------------------------------------------------
City | BENTON
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71006-0101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 870-918-4973
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
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 | AP09837
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------