Provider Demographics
NPI:1083236129
Name:WRIGHT, SONYA ELIZABETH (AGNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SONYA
Middle Name:ELIZABETH
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25969 FLINTONBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH RIDING
Mailing Address - State:VA
Mailing Address - Zip Code:20152-3643
Mailing Address - Country:US
Mailing Address - Phone:703-327-4140
Mailing Address - Fax:
Practice Address - Street 1:44055 RIVERSIDE PKWY STE 208
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-5176
Practice Address - Country:US
Practice Address - Phone:703-687-3601
Practice Address - Fax:703-687-3602
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAAG05200001363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAAG05200001Medicaid