Basic Information
| Provider Information | |||||||||
| NPI: | 1386076719 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DILLARD | ||||||||
| FirstName: | SONYA | ||||||||
| MiddleName: | LEIGH | ||||||||
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| Credential: | APN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2007 | ||||||||
| Address2: | |||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374090007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4237029240 | ||||||||
| FaxNumber: | 4237029245 | ||||||||
| Practice Location | |||||||||
| Address1: | 2051 HAMILL RD | ||||||||
| Address2: | |||||||||
| City: | HIXSON | ||||||||
| State: | TN | ||||||||
| PostalCode: | 373436614 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4237029240 | ||||||||
| FaxNumber: | 4237029245 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2013 | ||||||||
| LastUpdateDate: | 05/15/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 17822 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.