Provider Demographics
NPI:1629379417
Name:OHSIEK, SONJA SUMIKO (FNP)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:SUMIKO
Last Name:OHSIEK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9883 FLINT DR
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-4061
Mailing Address - Country:US
Mailing Address - Phone:801-403-3430
Mailing Address - Fax:
Practice Address - Street 1:54 N 800 W
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84116-3326
Practice Address - Country:US
Practice Address - Phone:801-359-0901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-09
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT218465-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily