Provider Demographics
NPI:1972689917
Name:ALBRIGHT, SONJA (FNP)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:
Last Name:ALBRIGHT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 S ASH ST
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:MO
Mailing Address - Zip Code:64772-3223
Mailing Address - Country:US
Mailing Address - Phone:417-667-3355
Mailing Address - Fax:417-448-3796
Practice Address - Street 1:345 S BARRETT LN
Practice Address - Street 2:
Practice Address - City:NEVADA
Practice Address - State:MO
Practice Address - Zip Code:64772-4255
Practice Address - Country:US
Practice Address - Phone:417-448-2439
Practice Address - Fax:417-549-6112
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO149431363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1972689917Medicaid
MOQ26334Medicare UPIN
MO718000035Medicare Oscar/Certification