Provider Demographics
NPI:1902528755
Name:BRANT, SOFIA JEANETTE (PA)
Entity type:Individual
Prefix:MS
First Name:SOFIA
Middle Name:JEANETTE
Last Name:BRANT
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Gender:F
Credentials:PA
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Mailing Address - Street 1:PO BOX 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-514-3500
Mailing Address - Fax:314-878-7678
Practice Address - Street 1:4921 PARKVIEW PL
Practice Address - Street 2:DEPT ORTHOPAEDIC SURGERY, STE 6A/6B/12A
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1032
Practice Address - Country:US
Practice Address - Phone:314-514-3500
Practice Address - Fax:314-878-7678
Is Sole Proprietor?:No
Enumeration Date:2022-09-16
Last Update Date:2025-10-27
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Provider Licenses
StateLicense IDTaxonomies
MO2022046199363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant