Individual provider Active NPI

Sonja Earlene Church, CNP

  • Family Nurse Practitioner
  • Kayenta, AZ
National Provider Identifier
1790073294
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
280785 Issued in AZ
Practice address
Hwy 160 M.P. 394.3
Kayenta, AZ 86033
Phone
(928) 697-4000
Fax
(928) 697-4145
NPI assigned
Jul 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN169034 AZ
Family Nurse Practitioner 363LF0000X 280785 AZ Primary

Addresses

Primary practice location

Hwy 160 M.P. 394.3
Kayenta, AZ 86033

Mailing address

PO Box 600
Tuba City, AZ 86045-0600
Phone (928) 283-2501

Other practice location 1

167 North Main Street
Tuba City, AZ 86045-0600
Phone (928) 283-2501

Other names 1

  • Sonja Earlene Crank Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN169034AZMDRegistered Nurse
280785AZMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1790073294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 600",
            "city": "TUBA CITY",
            "state": "AZ",
            "postal_code": "860450600",
            "telephone_number": "928-283-2501",
            "fax_number": "928-283-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HWY 160 M.P. 394.3",
            "city": "KAYENTA",
            "state": "AZ",
            "postal_code": "86033",
            "telephone_number": "928-697-4000",
            "fax_number": "928-697-4145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "167 North Main Street",
            "address_purpose": "LOCATION",
            "city": "Tuba City",
            "state": "AZ",
            "postal_code": "860450600",
            "country_code": "US",
            "telephone_number": "928-283-2501",
            "fax_number": "928-283-2677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "SONJA",
        "middle_name": "EARLENE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-18",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN169034",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "280785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SONJA",
            "last_name": "CRANK",
            "middle_name": "EARLENE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kayenta, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.