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General NPI Number Information
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NPI Number | 1588653596
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Entity Type | Individual
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Provider Name | KATHLEEN BONIN APRN
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Gender | Female
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Dates
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Enumeration Date | 10/21/2005
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Last Update Date | 01/10/2023
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Provider Practice Location Address
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Address Line | 42 TOWN ST STE 300
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City | NORWICH
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State | CT
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Zip | 06360-2339
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Country | US
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Telephone | 860-886-0567
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Fax | 860-886-0567
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Provider Business Mailing Address
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Address Line | 42 TOWN ST STE 300
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City | NORWICH
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State | CT
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Zip | 06360-2339
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Country | US
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Telephone | 860-886-0567
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Fax | 860-886-0567
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 002975
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 002975
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License Number State | CT
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