Individual
MISS BONNIE L SERVAGE
Active
Individual
MISS BONNIE L SERVAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F303309
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02331175
—
NY
01
—
7599474
GHI
NY
Enumeration date
05/24/2005
Last updated
10/25/2007
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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