Healthcare Provider Details

I. General information

NPI: 1982538088
Provider Name (Legal Business Name): FARRAH S BONNEY FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2205 EXECUTIVE DR STE D
HAMPTON VA
23666-2948
US

IV. Provider business mailing address

860 OMNI BLVD STE 401
NEWPORT NEWS VA
23606-4430
US

V. Phone/Fax

Practice location:
  • Phone: 757-825-4273
  • Fax: 757-825-4276
Mailing address:
  • Phone: 757-232-8860
  • Fax: 757-232-8875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024197719
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: