Provider Demographics
NPI:1306075346
Name:SOUSA, SONDRA N (RN, FNP-C)
Entity type:Individual
Prefix:MS
First Name:SONDRA
Middle Name:N
Last Name:SOUSA
Suffix:
Gender:F
Credentials:RN, FNP-C
Other - Prefix:
Other - First Name:SONDRA
Other - Middle Name:N
Other - Last Name:PLOEDERL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1001 YOSEMITE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-6003
Mailing Address - Country:US
Mailing Address - Phone:303-602-4545
Mailing Address - Fax:512-901-9762
Practice Address - Street 1:1001 YOSEMITE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-6003
Practice Address - Country:US
Practice Address - Phone:303-602-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO172615163W00000X
TX825537163W00000X
TXAP121948363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse