Provider Demographics
NPI:1548766439
Name:SONNEMANN, CAITLIN ROSE (MSN, FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:CAITLIN
Middle Name:ROSE
Last Name:SONNEMANN
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3073 BRUCKNER BLVD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-5614
Mailing Address - Country:US
Mailing Address - Phone:347-387-5151
Mailing Address - Fax:
Practice Address - Street 1:3073 BRUCKNER BLVD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-5614
Practice Address - Country:US
Practice Address - Phone:347-387-5151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-01
Last Update Date:2018-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF342798-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily