Provider Demographics
NPI:1871780957
Name:SONN, JENNIFER ANN
Entity type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:ANN
Last Name:SONN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 S HOPKINS ST
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70560-4323
Mailing Address - Country:US
Mailing Address - Phone:337-560-0909
Mailing Address - Fax:337-560-7707
Practice Address - Street 1:720 S HOPKINS ST
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70560-5246
Practice Address - Country:US
Practice Address - Phone:337-560-0909
Practice Address - Fax:337-364-6637
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-02
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA70543747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1019372Medicaid