Provider Demographics
NPI:1073689907
Name:VENT, SONIA M (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:M
Last Name:VENT
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 221606
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99522-1606
Mailing Address - Country:US
Mailing Address - Phone:907-360-5241
Mailing Address - Fax:
Practice Address - Street 1:6921 E GARTH CIR
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-5922
Practice Address - Country:US
Practice Address - Phone:907-376-1633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAK 166363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant