Provider Demographics
NPI:1578317558
Name:SHERIFF SONNAH, MAMIE FATMATA
Entity Type:Individual
Prefix:
First Name:MAMIE
Middle Name:FATMATA
Last Name:SHERIFF SONNAH
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 1:12430 GIRASOLE CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-2096
Mailing Address - Country:US
Mailing Address - Phone:832-434-5616
Mailing Address - Fax:
Practice Address - Street 1:12430 GIRASOLE CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-2096
Practice Address - Country:US
Practice Address - Phone:832-434-5616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX898866163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse