Provider Demographics
NPI:1902530462
Name:SOMMA, MARIANNE DAVIGNON (DNP)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:DAVIGNON
Last Name:SOMMA
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 RYAN NICHOLAS DR
Mailing Address - Street 2:
Mailing Address - City:KINGSLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31548-6939
Mailing Address - Country:US
Mailing Address - Phone:706-288-6683
Mailing Address - Fax:
Practice Address - Street 1:2500 STARLING ST STE 504
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-4270
Practice Address - Country:US
Practice Address - Phone:912-466-5593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN268874363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care