Provider Demographics
NPI:1104083005
Name:WEMHOFF, SONYA V (PA-C)
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:V
Last Name:WEMHOFF
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SONYA
Other - Middle Name:V
Other - Last Name:ROWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2725 S 144TH ST
Mailing Address - Street 2:#110
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-5243
Mailing Address - Country:US
Mailing Address - Phone:402-637-0400
Mailing Address - Fax:402-637-0400
Practice Address - Street 1:2725 S 144TH ST
Practice Address - Street 2:#110
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-5243
Practice Address - Country:US
Practice Address - Phone:402-637-0400
Practice Address - Fax:402-637-0400
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1388363A00000X
IA001891363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE092169002Medicare PIN
IAI83520009Medicare PIN