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Individual
BONITA J O'REILLY
Active
Individual
BONITA J O'REILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
47-04-102421
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104545456
—
MI
05
—
104545465
—
MI
05
—
104545483
—
MI
05
—
104545492
—
MI
Enumeration date
08/12/2005
Last updated
03/17/2018
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