Individual
SONJA NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8109 INTERSTATE 30, LITTLE ROCK, AR 72209-4840
(501) 562-5400
Mailing address
8109 INTERSTATE 30, LITTLE ROCK, AR 72209-4840
(501) 562-5400
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
R099223
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163W00000X
—
AR
Enumeration date
10/18/2017
Last updated
10/18/2017
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