Provider Demographics
NPI:1154706489
Name:PHILLIP A. SONNIER
Entity type:Organization
Organization Name:PHILLIP A. SONNIER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RNFA
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:SONNIER
Authorized Official - Suffix:
Authorized Official - Credentials:RNFA
Authorized Official - Phone:910-580-5338
Mailing Address - Street 1:1717 ELM ST
Mailing Address - Street 2:
Mailing Address - City:ANNA
Mailing Address - State:TX
Mailing Address - Zip Code:75409-4482
Mailing Address - Country:US
Mailing Address - Phone:910-580-5338
Mailing Address - Fax:
Practice Address - Street 1:1717 ELM ST
Practice Address - Street 2:
Practice Address - City:ANNA
Practice Address - State:TX
Practice Address - Zip Code:75409-4482
Practice Address - Country:US
Practice Address - Phone:910-580-5338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-28
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN170765163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Multi-Specialty