=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902982887
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SONIA L MCCLINTON DNP, FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/31/2006
-----------------------------------------------------
Last Update Date | 07/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 VETERANS WAY
-----------------------------------------------------
City | EGLIN AFB
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32542-1038
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-609-2750
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5160 BIRCH ST
-----------------------------------------------------
City | MERIDIAN
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39307-9145
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-527-3508
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | R860101
-----------------------------------------------------
License Number State | MS
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 11003040
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------