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General NPI Number Information
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NPI Number | 1417433350
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Entity Type | Individual
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Provider Name | SONYA LEE FIEBIG
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Gender | Female
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Dates
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Enumeration Date | 07/13/2018
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Last Update Date | 10/17/2021
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Provider Practice Location Address
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Address Line | 2151 S LAMAR BLVD
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City | AUSTIN
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State | TX
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Zip | 78704-4921
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Country | US
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Telephone | 860-575-6907
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Fax |
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Provider Business Mailing Address
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Address Line | 2151 S LAMAR BLVD
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City | AUSTIN
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State | TX
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Zip | 78704-4921
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Country | US
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Telephone | 860-575-6907
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Fax |
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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 | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 0001278201
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License Number State | VA
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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 | TAP11545
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP11545
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License Number State | AZ
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