Sophia M Mann
Individual provider Active NPI Licensed Practical Nurse · Fortson, GA
NPI 1922246768 · NPPES record last updated Feb 2, 2009
Key facts
- NPI
- 1922246768
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- LPN055336 (GA)
- Practice address
- 156 Raccoon Run
Fortson, GA 31808-7326 - Phone
- (706) 596-0383
- NPI assigned
- Feb 2, 2009
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPN055336 | GA | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LPN055336 | GA | Yes |
Addresses
Primary practice location
156 Raccoon Run
Fortson, GA 31808-7326
Mailing address
156 Raccoon Run
Fortson, GA 31808-7326
Phone (706) 596-0383
Other names
- Sophia M Petrey
Other providers in Fortson, GA
- Anndrea Marie Lampkin
- Simonne Lawrence
- Amber Love
- Love, Breanna Olivia Zion Enterprise,LLC(Lboz):
- Carrie Love
- Katherine Maxey
- Jennifer Elaine Miley
- Yasuko Musashi
- Netavia Dixon Offiong
- Amber Parks
All providers in Fortson, GA · Licensed Practical Nurse in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2009. 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.