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NPI Code Detail

MEDICARE: SHERIFA TAHIR BONKANO RN

MEDICARE: SHERIFA TAHIR BONKANO RN
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
1163W00000XRegistered Nurse359605NC

General Provider Information

NPI Number : 1689519241
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHERIFA TAHIR BONKANO RN
Provider Business Mailing Address
First Line : 124 E GATE CITY BLVD
Second Line :
City : GREENSBORO
State : NC
Zip : 27406-1457
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 124 E GATE CITY BLVD
Second Line :
City : GREENSBORO
State : NC
Zip : 27406-1457
Country : US
Telephone Number : 413-563-5069
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2026
Last Update Date : 04/21/2026

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