Provider Demographics
NPI:1558734012
Name:ADAMS, SONNYA NATRIA
Entity Type:Individual
Prefix:
First Name:SONNYA
Middle Name:NATRIA
Last Name:ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8722 LONGLAKE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67207
Mailing Address - Country:US
Mailing Address - Phone:316-214-6746
Mailing Address - Fax:
Practice Address - Street 1:8722 LONGLAKE CIRCLE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207
Practice Address - Country:US
Practice Address - Phone:316-214-6746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service