Provider Demographics
NPI:1578051801
Name:WEAVER, SONYA BONITA (PMHNP)
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:BONITA
Last Name:WEAVER
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4540 COCHISE TRL
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23237-2559
Mailing Address - Country:US
Mailing Address - Phone:804-439-2206
Mailing Address - Fax:804-743-2591
Practice Address - Street 1:2430 SOUTHLAND DR
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-2354
Practice Address - Country:US
Practice Address - Phone:804-439-2206
Practice Address - Fax:804-743-2591
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-23
Last Update Date:2025-05-29
Deactivation Date:2018-05-29
Deactivation Code:
Reactivation Date:2025-05-13
Provider Licenses
StateLicense IDTaxonomies
VA0024192291363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health