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General NPI Number Information
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NPI Number | 1710384482
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Entity Type | Individual
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Provider Name | BARBRA BONSU
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Gender | Female
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Dates
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Enumeration Date | 11/24/2014
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2421 RAMBLEWOOD DR
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City | DISTRICT HEIGHTS
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State | MD
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Zip | 20747-2343
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Country | US
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Telephone | 201-397-6694
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Fax |
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Provider Business Mailing Address
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Address Line | 9701 APOLLO DR STE 100
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City | LARGO
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State | MD
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Zip | 20774-4785
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Country | US
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Telephone | 240-397-6694
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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 | R213477
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License Number State | MD
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