Provider Demographics
NPI:1710477096
Name:FIMPLE, SONJA ELAINE (RN)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:ELAINE
Last Name:FIMPLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 MARSHALL DR N APT 1C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-8529
Mailing Address - Country:US
Mailing Address - Phone:253-301-7005
Mailing Address - Fax:
Practice Address - Street 1:343 MARSHALL DR N APT 1C
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-8529
Practice Address - Country:US
Practice Address - Phone:253-301-7005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-13
Last Update Date:2018-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY748408163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse