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General NPI Number Information
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NPI Number | 1497034458
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Entity Type | Individual
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Provider Name | JESSICA NICOLE BONIOL MSN, FNP-BC, APRN
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Gender | Female
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Dates
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Enumeration Date | 08/09/2011
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 5148 VILLAGE CREEK DR UNIT 300
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City | PLANO
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State | TX
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Zip | 75093-5064
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Country | US
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Telephone | 469-661-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 213 SPARROW HAWK
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City | MCKINNEY
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State | TX
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Zip | 75070-5849
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Country | US
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Telephone | 469-585-2713
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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 | AP120667
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 724324
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License Number State | TX
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