Provider Demographics
NPI:1710433792
Name:SONDERVAN, CORI ELIZABETH (APN, FNP-C)
Entity type:Individual
Prefix:MS
First Name:CORI
Middle Name:ELIZABETH
Last Name:SONDERVAN
Suffix:
Gender:F
Credentials:APN, FNP-C
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 751649
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1649
Mailing Address - Country:US
Mailing Address - Phone:888-472-0043
Mailing Address - Fax:843-724-2440
Practice Address - Street 1:1671 BELLE ISLE AVE STE 110J
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-8336
Practice Address - Country:US
Practice Address - Phone:844-994-6633
Practice Address - Fax:470-300-7913
Is Sole Proprietor?:No
Enumeration Date:2016-08-30
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00665200363LF0000X
SC28000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily