Provider Demographics
NPI:1881064145
Name:KOOIMA, SONYA KAY (PNP)
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:KAY
Last Name:KOOIMA
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:SONYA
Other - Middle Name:KAY
Other - Last Name:WASMUND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6285 S. HIGLEY RD.
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85298
Mailing Address - Country:US
Mailing Address - Phone:480-460-4949
Mailing Address - Fax:480-460-5858
Practice Address - Street 1:965 W. CHANDLER HEIGHTS RD.
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85248
Practice Address - Country:US
Practice Address - Phone:480-460-4949
Practice Address - Fax:480-460-5858
Is Sole Proprietor?:No
Enumeration Date:2015-09-30
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP8100363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics