Bonita Lois Martin
Nurse Practitioner - Gerontology
500 E Collin Raye Dr
De Queen
, Arkansas 71832-8048
Bonita Lois Martin
Nurse Practitioner - Gerontology
500 E Collin Raye Dr
De Queen
, Arkansas 71832-8048
(870) 784-2729
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About
Features
Specialties
- Nurse Practitioner - Gerontology
Languages spoken
- English
Location
First Address
- Bonita Lois Martin
- 358 Bridge Creek Rd
- Horatio, AR
- Zip : 71842-9000
- Phone : (870) 784-2729
Second Address
- Bonita Lois Martin
- 500 E Collin Raye Dr
- De Queen, AR
- Zip : 71832-8048
- Phone : (870) 584-1055
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LG0600X | Nurse Practitioner - Gerontology | 123723 | AR |
National Provider Identifier
| NPI | 1053950113 |
|---|---|
| Provider Name | Bonita Lois Martin |
| First Address | Horatio, AR 71842-9000 |
| Second Address | De Queen, AR 71832-8048 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/01/2020 |
| Last Update Date | 11/02/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.