Ms. Bonnie L Clark
Nurse Practitioner - Women's Health
5 Silver Rdg
Veazie
, Maine 04401-7086
Ms. Bonnie L Clark
Nurse Practitioner - Women's Health
5 Silver Rdg
Veazie
, Maine 04401-7086
(207) 942-0824
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About
Features
Specialties
- Nurse Practitioner - Women's Health
Languages spoken
- English
Location
First Address
- Ms. Bonnie L Clark
- 5 Silver Rdg
- Veazie, ME
- Zip : 04401-7086
- Fax : (207) 942-0824
- Phone : (207) 942-0824
Second Address
- Ms. Bonnie L Clark
- 5 Silver Rdg
- Veazie, ME
- Zip : 04401-7086
- Fax : (207) 942-0824
- Phone : (207) 942-0824
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Is Ms. Bonnie L Clark a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LW0102X | Nurse Practitioner - Women's Health | CNP81695 | ME |
National Provider Identifier
| NPI | 1063563310 |
|---|---|
| Provider Name | Ms. Bonnie L Clark |
| First Address | Veazie, ME 04401-7086 |
| Second Address | Veazie, ME 04401-7086 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/01/2007 |
| Last Update Date | 26/06/2013 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| CNP81695 | MAINE STATE BOARD OF NURSING (01) | ME |
| RN18038 | MAINE STATE BOARD OF NURSING (01) | ME |
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.