Provider Demographics
NPI:1740927284
Name:SOH, ONORINE AMI (NP)
Entity type:Individual
Prefix:
First Name:ONORINE
Middle Name:AMI
Last Name:SOH
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 1:4763 SUNFLOWER DR
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55129-1402
Mailing Address - Country:US
Mailing Address - Phone:952-486-0124
Mailing Address - Fax:
Practice Address - Street 1:4763 SUNFLOWER DR
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55129-1402
Practice Address - Country:US
Practice Address - Phone:952-486-0124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2021210065363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology