Individual
MRS. BONITA PONDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2720 LOGANVILLE HWY, LOGANVILLE, GA 30052-7715
(770) 277-5996
Mailing address
2720 LOGANVILLE HWY, LOGANVILLE, GA 30052-7715
(770) 277-5996
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN149123
GA
Other
Enumeration date
11/05/2012
Last updated
01/18/2020
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