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General NPI Number Information
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NPI Number | 1417941667
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Entity Type | Individual
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Provider Name | BONITA F. MCCRAY FNP
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Gender | Female
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Dates
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Enumeration Date | 09/02/2005
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Last Update Date | 05/08/2017
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Provider Practice Location Address
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Address Line | 1523 HERITAGE LN UNIT B
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City | FLORENCE
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State | SC
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Zip | 29505-3197
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Country | US
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Telephone | 908-494-8467
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Fax | 888-472-5145
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Provider Business Mailing Address
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Address Line | 1523 HERITAGE LN UNIT B
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City | FLORENCE
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State | SC
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Zip | 29505-3197
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Country | US
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Telephone | 908-494-8467
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Fax | 888-472-5145
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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 | APN723
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License Number State | SC
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