Individual
BONNIE LYNN GAUDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3333 SILAS CREEK PKWY, EMERGENCY DEPARTMENT, WINSTON SALEM, NC 27103-3013
(336) 275-3325
(336) 275-5346
Mailing address
PO BOX 75332, CHARLOTTE, NC 28275-0332
(336) 768-5762
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1334111
—
LA
Enumeration date
10/20/2005
Last updated
02/03/2009
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