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NPI Code Detail

MEDICARE: MRS. SONYA ODETTE CAROTHERS MSN,RN,FNP-BC

MEDICARE: MRS. SONYA ODETTE CAROTHERS MSN,RN,FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner547202TX

General Provider Information

NPI Number : 1013165059
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SONYA ODETTE CAROTHERS MSN,RN,FNP-BC
Provider Business Mailing Address
First Line : 13530 SCHUMANN TRL
Second Line :
City : SUGAR LAND
State : TX
Zip : 77498-3495
Country : US
Telephone Number : 281-704-0918
Fax Number :
Provider Business Practice Location Address
First Line : 8555 MEMORIAL BLVD STE 100
Second Line :
City : PORT ARTHUR
State : TX
Zip : 77640-7001
Country : US
Telephone Number : 409-237-6480
Fax Number : 833-749-0330
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2008
Last Update Date : 05/09/2023

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Directions to “ MRS. SONYA ODETTE CAROTHERS MSN,RN,FNP-BC” Practice Location

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