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General NPI Number Information
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NPI Number | 1073154548
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Entity Type | Individual
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Provider Name | LINDSAY MARIE BONNER RN
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Gender | Female
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Dates
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Enumeration Date | 10/04/2019
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Last Update Date | 10/04/2019
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Provider Practice Location Address
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Address Line | 3003 HEALTH CENTER DR
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City | SAN DIEGO
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State | CA
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Zip | 92123-2700
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Country | US
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Telephone | 858-939-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 4712 MOUNT GAYWAS DR
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City | SAN DIEGO
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State | CA
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Zip | 92117-3903
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Country | US
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Telephone | 858-922-5649
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WN0002X
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Taxonomy Name | Neonatal Intensive Care Registered Nurse
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License Number | 845085
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License Number State | CA
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