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General NPI Number Information
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NPI Number | 1689851875
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Entity Type | Individual
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Provider Name | SONYA KINNARD
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Gender | Female
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Dates
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Enumeration Date | 01/30/2008
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Last Update Date | 06/05/2019
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Provider Practice Location Address
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Address Line | 1970 HOSPITAL DR
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City | CLARKSDALE
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State | MS
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Zip | 38614-7202
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Country | US
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Telephone | 662-624-3211
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Fax |
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Provider Business Mailing Address
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Address Line | 1632 HARRAH'S PWKY S EXT. APT. #5101
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City | ROBINSONVILLE
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State | MS
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Zip | 38664
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Country | US
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Telephone | 662-363-2961
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP141211
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 078333
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License Number State | TN
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