Individual
MRS. NICOLE YOUNG SONNEBORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2258906
MA
363LP0200X
Pediatric Nurse Practitioner
Primary
RN2258906
MA
Other
Enumeration date
11/22/2010
Last updated
11/21/2016
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