Provider Demographics
NPI:1275973455
Name:BRADFORD-VARNER, SONYA L (FNP)
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:L
Last Name:BRADFORD-VARNER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:SONYA
Other - Middle Name:L
Other - Last Name:PUNZO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1122 N TOPEKA ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-2810
Mailing Address - Country:US
Mailing Address - Phone:316-866-2000
Mailing Address - Fax:316-866-2084
Practice Address - Street 1:1131 S CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-2955
Practice Address - Country:US
Practice Address - Phone:316-866-2000
Practice Address - Fax:316-866-2084
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2017-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013021888363LF0000X
KS53-77579363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201074590BMedicaid
MO1275973455Medicaid
KS201074590AMedicaid
MOF29A00044Medicare Oscar/Certification