MEDICARE: MRS. SONYA NICOLE HEAD ARNP

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	363LF0000X	Family Nurse Practitioner	9288581	FL

General Provider Information

NPI Number	:	1427480730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SONYA NICOLE HEAD ARNP

Provider Business Mailing Address
First Line	:	9900 BREN RD E
Second Line	:
City	:	MINNETONKA
State	:	MN
Zip	:	55343-9664
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5258 GLENWOOD AVE
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32205-7251
Country	:	US
Telephone Number	:	904-446-7406
Fax Number	:

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

Provider Enumeration Date	:	08/08/2013
Last Update Date	:	09/20/2020

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