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NPI Code Detail

MEDICARE: JASMINE BONILLA RN, BSN

MEDICARE: JASMINE BONILLA RN, BSN
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1366374662
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASMINE BONILLA RN, BSN
Provider Business Mailing Address
First Line : 404 W FOLTZ CT
Second Line :
City : GARDEN CITY
State : KS
Zip : 67846-2876
Country : US
Telephone Number : 620-875-0307
Fax Number :
Provider Business Practice Location Address
First Line : 404 W FOLTZ CT
Second Line :
City : GARDEN CITY
State : KS
Zip : 67846-2876
Country : US
Telephone Number : 620-875-0307
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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