MEDICARE: MS. SONIA BURNETT LVN

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	164X00000X	Licensed Vocational Nurse	143039	TX

General Provider Information

NPI Number	:	1356863161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SONIA BURNETT LVN

Provider Business Mailing Address
First Line	:	6108 ABRAMS RD APT 316
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-8029
Country	:	US
Telephone Number	:	682-221-5450
Fax Number	:

Provider Business Practice Location Address
First Line	:	6108 ABRAMS RD APT 316
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-8029
Country	:	US
Telephone Number	:	682-221-5450
Fax Number	:

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

Provider Enumeration Date	:	07/13/2017
Last Update Date	:	07/21/2022

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