Provider Demographics
NPI:1437478740
Name:CANFIELD, SONYA KAY (RN, APN)
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:KAY
Last Name:CANFIELD
Suffix:
Gender:F
Credentials:RN, APN
Other - Prefix:
Other - First Name:SONYA
Other - Middle Name:KAY
Other - Last Name:GRANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4301 W MARKHAM ST # 568
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-7101
Mailing Address - Country:US
Mailing Address - Phone:501-526-8200
Mailing Address - Fax:501-526-5296
Practice Address - Street 1:4301 W MARKHAM ST # 568
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-7101
Practice Address - Country:US
Practice Address - Phone:501-526-8200
Practice Address - Fax:501-526-5296
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR66879163WP0808X
ARA03465363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR189480758Medicaid
AR4A014Medicare PIN