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General NPI Number Information
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NPI Number | 1386026557
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Entity Type | Individual
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Provider Name | BONNIE RENEE PATRICK APRN
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Gender | Female
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Dates
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Enumeration Date | 06/24/2015
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Last Update Date | 09/22/2016
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Provider Practice Location Address
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Address Line | 55 TOWNSHIP ROAD 508 E
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City | SOUTH POINT
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State | OH
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Zip | 45680-7276
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Country | US
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Telephone | 740-377-2712
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Fax | 740-377-2588
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Provider Business Mailing Address
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Address Line | 305 N 5TH ST
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City | IRONTON
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State | OH
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Zip | 45638-1578
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Country | US
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Telephone | 740-532-3534
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Fax | 740-532-4859
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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 | 3009364
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License Number State | KY
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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 | 019848
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License Number State | OH
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