Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 721949 | TX |
NPI | 1033393897 |
---|---|
Provider Name | Mrs. Cheryl Joy Bonecutter |
First Address | San Antonio, TX 78256-2301 |
Second Address | San Antonio, TX 78256-2301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2007 |
Last Update Date | 28/12/2007 |