Basic Information
Provider Information
NPI: 1003872920
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JURGENS
FirstName: SONYA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8717 W 110TH ST
Address2: SUITE 600
City: OVERLAND PARK
State: KS
PostalCode: 662102144
CountryCode: US
TelephoneNumber: 9134282900
FaxNumber: 9134282951
Practice Location
Address1: 5721 W 119TH ST
Address2:  
City: OVERLAND PARK
State: KS
PostalCode: 662093722
CountryCode: US
TelephoneNumber: 9134282900
FaxNumber: 9134282951
Other Information
ProviderEnumerationDate: 04/21/2006
LastUpdateDate: 01/26/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X55006KSY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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