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NPI Code Detail

MEDICARE: MR. DONALD L BONS FNP-BC

MEDICARE: MR. DONALD L BONS FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner201391732NP-PPOR

General Provider Information

NPI Number : 1073946711
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DONALD L BONS FNP-BC
Provider Business Mailing Address
First Line : 1007 CORNUTT ST
Second Line :
City : MYRTLE CREEK
State : OR
Zip : 97457-9392
Country : US
Telephone Number : 503-949-8357
Fax Number :
Provider Business Practice Location Address
First Line : 525 W UMPQUA ST
Second Line :
City : ROSEBURG
State : OR
Zip : 97471-2952
Country : US
Telephone Number : 541-464-7100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2013
Last Update Date : 08/02/2023

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