Provider Demographics
NPI:1821071275
Name:LONDA, SONYA JOY (CRNA)
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:JOY
Last Name:LONDA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:SONYA
Other - Middle Name:JOY
Other - Last Name:SCANLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:1004 SOUTH ROCK STREET
Mailing Address - Street 2:EASTER MEDICAL STAFFING
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626
Mailing Address - Country:US
Mailing Address - Phone:512-374-1876
Mailing Address - Fax:512-371-8788
Practice Address - Street 1:1004 SOUTH ROCK STREET
Practice Address - Street 2:EASTER MEDICAL STAFFING
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626
Practice Address - Country:US
Practice Address - Phone:512-374-1876
Practice Address - Fax:512-371-8788
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX48827367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175740301Medicaid
TX85555UOtherBC/BS
S65716Medicare UPIN
TX8D8776Medicare PIN