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Individual
STACI L BONDS
Active
Individual
STACI L BONDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
20913193
IL
363LF0000X
Family Nurse Practitioner
Primary
277.001908
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209-013193
STATE LICENSE
IL
Enumeration date
09/24/2015
Last updated
06/09/2022
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