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General NPI Number Information
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NPI Number | 1265781298
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Entity Type | Individual
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Provider Name | CYNTHIA OLUYEMI LAKIA BONIN-OMONIYI DNP, FNP-C, APRN
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Gender | Female
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Dates
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Enumeration Date | 09/05/2012
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Last Update Date | 01/05/2023
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Provider Practice Location Address
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Address Line | 1210 CORYELL CITY RD
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City | GATESVILLE
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State | TX
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Zip | 76528-2913
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Country | US
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Telephone | 409-772-1011
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Fax |
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Provider Business Mailing Address
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Address Line | 1210 CORYELL CITY RD
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City | GATESVILLE
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State | TX
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Zip | 76528-2913
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Country | US
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Telephone | 409-772-1011
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 761411
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP121104
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License Number State | TX
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