Provider Demographics
NPI:1275759672
Name:SONNIER, BRENDA C (NP)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:C
Last Name:SONNIER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 5TH ST
Mailing Address - Street 2:
Mailing Address - City:GUEYDAN
Mailing Address - State:LA
Mailing Address - Zip Code:70542-3612
Mailing Address - Country:US
Mailing Address - Phone:337-536-9262
Mailing Address - Fax:
Practice Address - Street 1:710 5TH ST
Practice Address - Street 2:
Practice Address - City:GUEYDAN
Practice Address - State:LA
Practice Address - Zip Code:70542-3612
Practice Address - Country:US
Practice Address - Phone:337-536-9262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP05154363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1012084Medicaid