Individual
MISS KRYSTINA KACEE BONILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
326 NICHOLS RD, FITCHBURG, MA 01420-1914
(978) 878-8100
Mailing address
326 NICHOLS RD, FITCHBURG, MA 01420-1914
(978) 606-1472
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN2278255
MA
Other
Enumeration date
09/24/2020
Last updated
10/21/2020
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