Individual
SONIA LASTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
15 SW EVERETT MALL WAY STE A, EVERETT, WA 98204-2715
(601) 670-0783
Mailing address
107 COTTON CRK, HATTIESBURG, MS 39402-7614
(601) 670-0783
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
902067
MS
363LF0000X
Family Nurse Practitioner
902067
MS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
61324878
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09925857
—
MS
Enumeration date
05/23/2017
Last updated
08/02/2022
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