Provider Demographics
NPI:1154167575
Name:POLEY, SOPHIA JANE (DNP, FNP-BC)
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:JANE
Last Name:POLEY
Suffix:
Gender:
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:SOPHIA
Other - Middle Name:JANE
Other - Last Name:MAPES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:888 W BIG BEAVER RD STE 900
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-4771
Mailing Address - Country:US
Mailing Address - Phone:248-629-2880
Mailing Address - Fax:248-319-6493
Practice Address - Street 1:888 W BIG BEAVER RD STE 900
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-4771
Practice Address - Country:US
Practice Address - Phone:248-629-2880
Practice Address - Fax:248-319-6493
Is Sole Proprietor?:No
Enumeration Date:2024-07-04
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0036767363L00000X
MI4704375644363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner