Doctor Name: | ANISSA L. SONNTAG |
NPI Number: | 1033231121 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | 44373 |
Business Practice Address: | 222 S Main Russell, KS - 67665 |
Business Phone Number: | 7854833333 |
Business Fax Number: | 7854837631 |
Mailing Address: | 200 S Main, RUSSELL |
State: | KS |
Postal Code: | 67665 |
Phone Number: | 7854833131 |
Fax Number: | 7854834859 |
NPI Enumeration Date: | 04/06/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 44373 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |