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General NPI Number Information
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NPI Number | 1669411419
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Entity Type | Individual
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Provider Name | BONNIE A O'CONNELL NP
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Gender | Female
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 07/16/2014
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Provider Practice Location Address
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Address Line | 4 BIRCH ST
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City | DERRY
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State | NH
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Zip | 03038-2136
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Country | US
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Telephone | 603-434-1354
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Fax |
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Provider Business Mailing Address
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Address Line | 3 CRICKET HILL DR
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City | AMHERST
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State | NH
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Zip | 03031-2019
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Country | US
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Telephone |
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 0212512304
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License Number State | NH
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