Provider Demographics
NPI:1578529665
Name:PRICE, SONDRA U (ARNP)
Entity Type:Individual
Prefix:
First Name:SONDRA
Middle Name:U
Last Name:PRICE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 HIGH ST
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-6300
Mailing Address - Country:US
Mailing Address - Phone:270-885-8445
Mailing Address - Fax:270-885-1216
Practice Address - Street 1:1717 HIGH ST
Practice Address - Street 2:SUITE 3A
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-6300
Practice Address - Country:US
Practice Address - Phone:270-885-8445
Practice Address - Fax:270-885-1216
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4549P363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000367593OtherANTHEM
KY78013992Medicaid
KY78013992Medicaid
KY0768304Medicare ID - Type Unspecified