Provider Demographics
NPI:1457896177
Name:AYANO, SOSINA
Entity Type:Individual
Prefix:MRS
First Name:SOSINA
Middle Name:
Last Name:AYANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 HUNTERS GLN
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-4375
Mailing Address - Country:US
Mailing Address - Phone:469-774-1057
Mailing Address - Fax:866-432-9632
Practice Address - Street 1:820 HUNTERS GLN
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:TX
Practice Address - Zip Code:75094-4375
Practice Address - Country:US
Practice Address - Phone:469-774-1057
Practice Address - Fax:866-432-9632
Is Sole Proprietor?:No
Enumeration Date:2017-01-04
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver