Provider Demographics
NPI:1013165059
Name:CAROTHERS, SONYA ODETTE (MSN,RN,FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:SONYA
Middle Name:ODETTE
Last Name:CAROTHERS
Suffix:
Gender:F
Credentials:MSN,RN,FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13530 SCHUMANN TRL
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-3495
Mailing Address - Country:US
Mailing Address - Phone:281-704-0918
Mailing Address - Fax:
Practice Address - Street 1:8555 MEMORIAL BLVD STE 100
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77640-7001
Practice Address - Country:US
Practice Address - Phone:409-237-6480
Practice Address - Fax:833-749-0330
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-03
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX547202363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily