1912201047 NPI number — SONYA ULRICA BROWN CRNA

Table of content: SONYA ULRICA BROWN CRNA (NPI 1912201047)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912201047 NPI number — SONYA ULRICA BROWN CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWN
Provider First Name:
SONYA
Provider Middle Name:
ULRICA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FULTON
Provider Other First Name:
SONYA
Provider Other Middle Name:
ULRICA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1912201047
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/04/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
525 MONTANA DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STAHLSTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15687-1340
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-593-2190
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4800 FRIENDSHIP AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15224-1722
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-394-4445
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/04/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  RN555237 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)