Provider Demographics
NPI:1538344619
Name:PRESTON, SONIA YVETTE (NP)
Entity type:Individual
Prefix:
First Name:SONIA
Middle Name:YVETTE
Last Name:PRESTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1347
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36202-1347
Mailing Address - Country:US
Mailing Address - Phone:256-832-0100
Mailing Address - Fax:256-832-0327
Practice Address - Street 1:608 MARTIN LUTHER KING DR
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36201-7344
Practice Address - Country:US
Practice Address - Phone:256-832-0100
Practice Address - Fax:256-832-0327
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-071593363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner