Individual
SONYA RENEE PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
111 DOCTOR CIR, COLUMBIA, SC 29203-6502
(800) 491-0909
Mailing address
111 DOCTOR CIR, COLUMBIA, SC 29203-6502
(800) 491-0909
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
20299
SC
363LA2100X
Acute Care Nurse Practitioner
9302684
FL
363LA2200X
Adult Health Nurse Practitioner
9302684
FL
363LG0600X
Gerontology Nurse Practitioner
9302684
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP4120
—
SC
Enumeration date
04/17/2015
Last updated
11/08/2022
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