Individual
NICOLE BONANNI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
301 SAINT PAUL PL, THE ORTHOPEDIC SPECIALTY HOSPITAL, BALTIMORE, MD 21202-2102
(410) 332-9000
Mailing address
301 SAINT PAUL PL, BALTIMORE, MD 21202-2102
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
C0005565
MD
Other
Enumeration date
10/28/2014
Last updated
10/28/2014
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