Sonya Antoinette Brackett, R.N.
Individual provider Active NPI Registered Nurse · Derby, NY
NPI 1104125905 · NPPES record last updated Mar 18, 2011
Key facts
- NPI
- 1104125905
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 396993-1 (NY)
- Practice address
- 6818 Erie Rd
Derby, NY 14047-9783 - Phone
- (716) 562-7012
- Fax
- (716) 562-7109
- NPI assigned
- Mar 18, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 396993-1 | NY | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A-Plus Home Health Care Agency, LLC | Past | Accepting new patients | |
| A Plus Home Health Care Agency, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 396993-1 | NY | Yes |
Addresses
Primary practice location
6818 Erie Rd
Derby, NY 14047-9783
Mailing address
PO Box 296
Derby, NY 14047-0296
Phone (716) 562-7012
Other providers in Derby, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.