Individual
BONNIE MARIE PAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
24430 STONE SPRINGS BLVD STE 515, DULLES, VA 20166-2268
(571) 385-1221
(800) 223-4063
Mailing address
PO BOX 12369, MURFREESBORO, TN 37129-0048
(844) 893-0012
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
0110002143
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417027608
RMH GROUP NPI
VA
01
—
1447764857
TWELVESTONE GROUP NPI
VA
01
—
1538316203
GROUP NPI
VA
Enumeration date
01/10/2007
Last updated
05/22/2025
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