Provider Demographics
NPI:1376248948
Name:PATIRAM, SONIA MELISSIA (FNP-C)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:MELISSIA
Last Name:PATIRAM
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6275 LANGDON VILLAGE CT
Mailing Address - Street 2:
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012-8006
Mailing Address - Country:US
Mailing Address - Phone:347-296-5066
Mailing Address - Fax:
Practice Address - Street 1:1320 N HAMILTON ST STE 105
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-2731
Practice Address - Country:US
Practice Address - Phone:336-905-7174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC265406363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily