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General NPI Number Information
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NPI Number | 1881756237
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Entity Type | Individual
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Provider Name | BONNIE BOCK CRNP
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Gender | Female
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 07/18/2013
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Provider Practice Location Address
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Address Line | 2 COLLEGE HL WELLNESS CENTER - WINSLOW CENTER
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City | WESTMINSTER
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State | MD
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Zip | 21157-4303
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Country | US
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Telephone | 410-857-2243
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Fax |
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Provider Business Mailing Address
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Address Line | 2945 TALBERT CT
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City | FINKSBURG
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State | MD
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Zip | 21048-1948
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Country | US
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Telephone | 410-751-5350
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | R076572
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License Number State | MD
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