Basic Information
Provider Information | |||||||||
NPI: | 1912999517 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | WILLIAMS | ||||||||
FirstName: | SONYA | ||||||||
MiddleName: | B. | ||||||||
NamePrefix: | MS. | ||||||||
NameSuffix: |   | ||||||||
Credential: | C.R.N.P. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | BECHTEL | ||||||||
OtherFirstName: | SONYA | ||||||||
OtherMiddleName: | R. | ||||||||
OtherNamePrefix: | MS. | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | C.R.N.P. | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 1111 BENFIELD BLVD | ||||||||
Address2: | SUITE 100 | ||||||||
City: | MILLERSVILLE | ||||||||
State: | MD | ||||||||
PostalCode: | 211083002 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4107295100 | ||||||||
FaxNumber: | 4107295156 | ||||||||
Practice Location | |||||||||
Address1: | 1509 RITCHIE HWY | ||||||||
Address2: |   | ||||||||
City: | ARNOLD | ||||||||
State: | MD | ||||||||
PostalCode: | 210122742 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4107577600 | ||||||||
FaxNumber: | 4106268043 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 08/19/2005 | ||||||||
LastUpdateDate: | 01/24/2011 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | R154267 | MD | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
ID | Type | State | Issuer | Description | 6279843 | 01 | MD | AETNA HMO | OTHER | 640732-02 | 01 | MD | CAREFIRST MD RENDERING | OTHER | 7202558 | 01 | MD | AETNA PPO | OTHER | 7605-0073 | 01 | MD | CAREFIRST BLUECHOICE | OTHER | P00256986 | 01 | MD | RAILROAD MEDICARE | OTHER | 111137 | 01 | MD | JHHC PROVIDER NUMBER | OTHER | 407664800 | 05 | MD |   | MEDICAID |