Individual
KRISTEN G BONAVILLA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
24 FLICKINGER CT, AMHERST, NY 14228-3393
(610) 428-5286
Mailing address
24 FLICKINGER CT, AMHERST, NY 14228-3395
(610) 428-5286
Taxonomy
Speciality
Code
Description
License number
State
163WX0002X
High-Risk Obstetric Registered Nurse
Primary
558493-1
NY
176B00000X
Midwife
001205-1
NY
Other
Enumeration date
05/25/2006
Last updated
09/11/2025
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