MEDICARE: BONNIE BARE

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
1	225C00000X	Rehabilitation Counselor

General Provider Information

NPI Number	:	1184920241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BONNIE BARE

Provider Business Mailing Address
First Line	:	727 FAIRVIEW DR
Second Line	:	STE A
City	:	CARSON CITY
State	:	NV
Zip	:	89701
Country	:	US
Telephone Number	:	775-687-5018
Fax Number	:	775-687-1181

Provider Business Practice Location Address
First Line	:	RURAL CLINICS BATTLE MOUNTAIN
Second Line	:	825 N. 2ND STREET
City	:	BATTLE MOUNTAIN
State	:	NV
Zip	:	89820-2834
Country	:	US
Telephone Number	:	775-635-5753
Fax Number	:	775-635-8028

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2011
Last Update Date	:	12/28/2021

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1548350895 — STATE OF NEVADA
Practice Location Address:

825 N 2ND ST
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1447743703 — COUNTY OF LANDER
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1285631580 — DAVID A BIRNBAUM M.D.
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1851350367 — MILLS PHARMACY
Practice Location Address:

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Directions to “ BONNIE BARE ” Practice Location

Language	Start Address	Practice Location

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