Provider Demographics
NPI:1407261266
Name:MCCARTY, SONYA D (APRN, FNP-C)
Entity type:Individual
Prefix:MISS
First Name:SONYA
Middle Name:D
Last Name:MCCARTY
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 E STONER AVE BLDG 55
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-4243
Mailing Address - Country:US
Mailing Address - Phone:318-990-4992
Mailing Address - Fax:318-990-5776
Practice Address - Street 1:244 BOND ST
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:LA
Practice Address - Zip Code:71251-5334
Practice Address - Country:US
Practice Address - Phone:318-259-1100
Practice Address - Fax:318-259-1333
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF06141064363LF0000X
LA224335363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily