Provider Demographics
NPI:1407254527
Name:GREENFIELD, SONJA KELLY (CPNP-PC/AC)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:KELLY
Last Name:GREENFIELD
Suffix:
Gender:F
Credentials:CPNP-PC/AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 CLIFTON RD NE FL 4
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-1060
Mailing Address - Country:US
Mailing Address - Phone:404-785-2311
Mailing Address - Fax:404-785-6233
Practice Address - Street 1:1405 CLIFTON RD NE FL 4
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1060
Practice Address - Country:US
Practice Address - Phone:404-785-2311
Practice Address - Fax:404-785-6233
Is Sole Proprietor?:No
Enumeration Date:2014-12-06
Last Update Date:2024-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704226713363L00000X, 363LP0200X
GARN301986363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics