Provider Demographics
NPI:1922617216
Name:BREEDING, SONYA
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:
Last Name:BREEDING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3692 HICKORY POINTE CT
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41102-7062
Mailing Address - Country:US
Mailing Address - Phone:304-617-7117
Mailing Address - Fax:
Practice Address - Street 1:3692 HICKORY POINTE CT
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41102-7062
Practice Address - Country:US
Practice Address - Phone:304-617-7117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV66721163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse