Provider Demographics
NPI:1093048092
Name:GIVENS, SONJA MICHELLE (LPN)
Entity Type:Individual
Prefix:MISS
First Name:SONJA
Middle Name:MICHELLE
Last Name:GIVENS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1416 NATCHITOCHES ST
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71292-3751
Mailing Address - Country:US
Mailing Address - Phone:318-362-5430
Mailing Address - Fax:318-362-5428
Practice Address - Street 1:1416 NATCHITOCHES ST
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71292-3751
Practice Address - Country:US
Practice Address - Phone:318-362-5430
Practice Address - Fax:318-362-5428
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA200075164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse