1851628382 NPI number — MS. SONYA LANNIRE MERIDETH R.D.H.

Table of content: MS. SONYA LANNIRE MERIDETH R.D.H. (NPI 1851628382)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851628382 NPI number — MS. SONYA LANNIRE MERIDETH R.D.H.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MERIDETH
Provider First Name:
SONYA
Provider Middle Name:
LANNIRE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
R.D.H.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851628382
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/04/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7549 W. CACTUS RD.
Provider Second Line Business Mailing Address:
#104-221
Provider Business Mailing Address City Name:
PEORIA
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85381
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
678-642-3257
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
926 E. MCDOWELL RD.
Provider Second Line Business Practice Location Address:
STE 120
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-253-0994
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/04/2009

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: 124Q00000X , with the licence number:  H6356 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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