Provider Demographics
NPI:1952886806
Name:PIPPINS, SONYA N (NP)
Entity Type:Individual
Prefix:MRS
First Name:SONYA
Middle Name:N
Last Name:PIPPINS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SONYA
Other - Middle Name:NICOLE
Other - Last Name:MOMENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1211 SOUTH GLOSTER
Mailing Address - Street 2:SUITE A
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801
Mailing Address - Country:US
Mailing Address - Phone:662-767-4200
Mailing Address - Fax:662-767-4204
Practice Address - Street 1:1211 SOUTH GLOSTER
Practice Address - Street 2:SUITE A
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801
Practice Address - Country:US
Practice Address - Phone:662-767-4200
Practice Address - Fax:662-767-4204
Is Sole Proprietor?:No
Enumeration Date:2018-09-26
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS902681363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner