Provider Demographics
NPI:1407208135
Name:KERTH, SONJA (DNP)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:
Last Name:KERTH
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7975 N HAYDEN RD
Mailing Address - Street 2:STE D354
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-3243
Mailing Address - Country:US
Mailing Address - Phone:480-214-9720
Mailing Address - Fax:480-214-9722
Practice Address - Street 1:11209 N TATUM BLVD STE 180
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-6016
Practice Address - Country:US
Practice Address - Phone:602-494-5155
Practice Address - Fax:602-494-5115
Is Sole Proprietor?:No
Enumeration Date:2016-07-06
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTAP8801363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily