Provider Demographics
NPI:1790456986
Name:FIZET, SONIA SUEZETTE (APRN)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:SUEZETTE
Last Name:FIZET
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1353 E MARKET ST STE 301
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-6626
Mailing Address - Country:US
Mailing Address - Phone:330-841-9020
Mailing Address - Fax:330-841-1124
Practice Address - Street 1:1353 E MARKET ST STE 301
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-6626
Practice Address - Country:US
Practice Address - Phone:330-841-9020
Practice Address - Fax:330-841-1124
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-27
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLE-000383-20363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty