Provider Demographics
NPI:1578964037
Name:STICE, SONJA LEA (APRN)
Entity Type:Individual
Prefix:MRS
First Name:SONJA
Middle Name:LEA
Last Name:STICE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:SONJA
Other - Middle Name:LEA
Other - Last Name:MANGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:670 J RD
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:KS
Mailing Address - Zip Code:67669-8821
Mailing Address - Country:US
Mailing Address - Phone:785-302-1090
Mailing Address - Fax:785-588-4623
Practice Address - Street 1:2810 PLAZA AVE
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-1924
Practice Address - Country:US
Practice Address - Phone:785-302-1090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-120877-032163W00000X
NE114204363LF0000X
KS2022003048363LP0808X
NE2022003048363LP0808X
KS53-78895-032363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health