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General NPI Number Information
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NPI Number | 1861672081
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Entity Type | Individual
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Provider Name | SONIA JEAN SHOUP APN
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Gender | Female
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Dates
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Enumeration Date | 11/05/2007
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 14901 E RINCON CREEK RANCH RD
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City | TUCSON
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State | AZ
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Zip | 85747
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Country | US
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Telephone | 832-266-9942
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Fax |
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Provider Business Mailing Address
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Address Line | 3003 N CENTRAL AVE
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City | PHOENIX
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State | AZ
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Zip | 85012-2902
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Country | US
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Telephone | 832-266-9942
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP7803
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP7803
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License Number State | AZ
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