Provider Demographics
NPI:1962015032
Name:SONDAG, SABRINA (DNP)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:SONDAG
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:SABRINA
Other - Middle Name:
Other - Last Name:MAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2001 W 21ST ST
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-4086
Mailing Address - Country:US
Mailing Address - Phone:575-935-1625
Mailing Address - Fax:
Practice Address - Street 1:2001 W 21ST ST
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-4086
Practice Address - Country:US
Practice Address - Phone:575-935-1625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ244724163W00000X
NM79656363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse