Provider Demographics
NPI:1043651276
Name:CROSS, SONJA (RN)
Entity type:Individual
Prefix:MS
First Name:SONJA
Middle Name:
Last Name:CROSS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CMR 457 BOX 609
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09033-0007
Mailing Address - Country:US
Mailing Address - Phone:01516-450-2504
Mailing Address - Fax:
Practice Address - Street 1:UNIT 25850 BOX 7
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09033-5850
Practice Address - Country:US
Practice Address - Phone:0972-196-6580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE65979163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse