Provider Demographics
NPI:1245743913
Name:THOMAS, SONYA RENEE (APRN)
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:RENEE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SONYA
Other - Middle Name:RENEE
Other - Last Name:PETERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:1982 OLD PLAIN DEALING RD
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:LA
Mailing Address - Zip Code:71006-0101
Mailing Address - Country:US
Mailing Address - Phone:870-918-4973
Mailing Address - Fax:
Practice Address - Street 1:1541 KINGS HIGHWAY
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71103-8843
Practice Address - Country:US
Practice Address - Phone:318-646-0050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-15
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP09837363LF0000X
ARA005409363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily