Individual
LATOYA N BONAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3308 SAMSON WAY STE 101, BELLEVUE, NE 68123
(402) 717-0450
Mailing address
7261 MERCY RD, OMAHA, NE 68124-2311
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
112653
NE
Other
Enumeration date
12/07/2018
Last updated
11/04/2024
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