Individual
BONNA PEARL MAYNIGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2908 SIR THOMAS DR, CHESAPEAKE, VA 23321-4580
(757) 672-1448
Mailing address
2908 SIR THOMAS DR, CHESAPEAKE, VA 23321-4580
(757) 672-1448
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
0024187441
VA
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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