MEDICARE: JESSICA NICOLE SONNIER MD

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
1	207Q00000X	Family Medicine Physician	MD.204676	LA

General Provider Information

NPI Number	:	1205094687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA NICOLE SONNIER MD

Provider Business Mailing Address
First Line	:	4918 E WESTRIDGE PARK DR
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70605-6762
Country	:	US
Telephone Number	:	337-478-3182
Fax Number	:	337-478-3182

Provider Business Practice Location Address
First Line	:	4918 E WESTRIDGE PARK DR
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70605-6762
Country	:	US
Telephone Number	:	337-478-3182
Fax Number	:	337-478-3182

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2008
Last Update Date	:	02/12/2025

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