Provider Demographics
NPI:1891234068
Name:ROY, SONIA (RN)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:
Last Name:ROY
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 1:20861 HARVEST MILL CT
Mailing Address - Street 2:
Mailing Address - City:GREAT MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20634-3318
Mailing Address - Country:US
Mailing Address - Phone:677-701-2091
Mailing Address - Fax:
Practice Address - Street 1:20861 HARVEST MILL CT
Practice Address - Street 2:
Practice Address - City:GREAT MILLS
Practice Address - State:MD
Practice Address - Zip Code:20634-3318
Practice Address - Country:US
Practice Address - Phone:677-701-2091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR161611163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse