Provider Demographics
NPI:1346803640
Name:MASSEY, SOPHIA ELIZABETH (DNP, FNP-C)
Entity Type:Individual
Prefix:
First Name:SOPHIA
Middle Name:ELIZABETH
Last Name:MASSEY
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4725 VILLAGE PLAZA LOOP STE 100
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-6677
Mailing Address - Country:US
Mailing Address - Phone:541-603-7930
Mailing Address - Fax:
Practice Address - Street 1:4725 VILLAGE PLAZA LOOP STE 100
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-6677
Practice Address - Country:US
Practice Address - Phone:541-603-7930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-22
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202009568NP-PP363LF0000X, 363L00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program