Provider Demographics
NPI:1265426860
Name:HANNIGAN, SONJA ABIGAIL (MSN)
Entity type:Individual
Prefix:
First Name:SONJA
Middle Name:ABIGAIL
Last Name:HANNIGAN
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:SONJA
Other - Middle Name:ABIGAIL
Other - Last Name:GREENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN
Mailing Address - Street 1:3418 PENNINGTON AVE S
Mailing Address - Street 2:
Mailing Address - City:AFTON
Mailing Address - State:MN
Mailing Address - Zip Code:55001-9740
Mailing Address - Country:US
Mailing Address - Phone:651-436-2659
Mailing Address - Fax:
Practice Address - Street 1:1 SANSOME ST STE 3500
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-4436
Practice Address - Country:US
Practice Address - Phone:604-423-4050
Practice Address - Fax:604-243-6214
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1194012363LF0000X
CA95080546363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q21884Medicare UPIN
500002677Medicare ID - Type Unspecified