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General NPI Number Information
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NPI Number | 1841627353
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Entity Type | Individual
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Provider Name | BAOKIM NGUYEN BONELLI PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/28/2013
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 17 WELLS ST STE 203
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City | WESTERLY
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State | RI
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Zip | 02891-2923
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Country | US
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Telephone | 401-348-0660
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Fax | 401-348-3090
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Provider Business Mailing Address
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Address Line | 15 LA SALLE SQ
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City | PROVIDENCE
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State | RI
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Zip | 02903-1814
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Country | US
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Telephone | 401-444-6779
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA01411
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License Number State | RI
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