Provider Demographics
NPI:1336770890
Name:GARRETT, SUNNI LYN (NP)
Entity Type:Individual
Prefix:
First Name:SUNNI
Middle Name:LYN
Last Name:GARRETT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2643 BUSINESS LOOP 181 N
Mailing Address - Street 2:
Mailing Address - City:FLORESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78114-6519
Mailing Address - Country:US
Mailing Address - Phone:956-532-4858
Mailing Address - Fax:
Practice Address - Street 1:133 PERCH HORIZON
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-5891
Practice Address - Country:US
Practice Address - Phone:956-532-4858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-03
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX861651163W00000X
TXAP145066363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse