Individual
BRANDY NICOLE BONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPH, MPAS, PA-C
Contact information
Practice address
3573 HILLSBOROUGH RD, DURHAM, NC 27705-2916
(866) 389-2727
Mailing address
3573 HILLSBOROUGH RD, DURHAM, NC 27705-2916
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001007717
NC
363A00000X
Physician Assistant
PA9109665

FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018572900
—
FL
Enumeration date
07/21/2016
Last updated
03/25/2021
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