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General NPI Number Information
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NPI Number | 1851190722
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Entity Type | Individual
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Provider Name | ANA CAROLYN BONILLA MSN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/12/2025
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 4684 ROSWELL RD STE B
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City | ATLANTA
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State | GA
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Zip | 30342-3074
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Country | US
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Telephone | 404-367-9005
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Fax | 678-240-4188
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Provider Business Mailing Address
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Address Line | 6500 ARIA BLVD APT 565
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City | SANDY SPRINGS
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State | GA
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Zip | 30328-3684
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Country | US
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Telephone | 507-316-2896
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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 | GAA-NP002555
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License Number State | GA
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