Provider Demographics
NPI:1245890862
Name:NOBLE, SONDRA JANE (APRN)
Entity type:Individual
Prefix:
First Name:SONDRA
Middle Name:JANE
Last Name:NOBLE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 MARIE ROBERTS RD
Mailing Address - Street 2:
Mailing Address - City:LOST CREEK
Mailing Address - State:KY
Mailing Address - Zip Code:41348-9010
Mailing Address - Country:US
Mailing Address - Phone:859-940-6226
Mailing Address - Fax:
Practice Address - Street 1:1100 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:KY
Practice Address - Zip Code:40336-7231
Practice Address - Country:US
Practice Address - Phone:606-726-9410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3013470363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3013470OtherAPRN LICENSE NUMBER