Individual
BONITA A CUMMINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
7922 S BROADWAY AVE, TYLER, TX 75703-5242
(903) 245-6695
Mailing address
9319 RASPBERRY AVE, FRANKSTON, TX 75763-4309
(903) 504-2894
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
849445
TX
Other
Enumeration date
08/20/2020
Last updated
08/20/2020
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