Individual
IMELDA AWUOR BONNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
4320 BLAND RD, RALEIGH, NC 27609-6125
(919) 417-4322
Mailing address
284 EXECUTIVE PARK DRIVE, SUITE 100, CONCORD, NC 28025-1894
(704) 939-1100
(704) 939-1173
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1028675
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
257911
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
5019103
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140149
—
AZ
Enumeration date
09/29/2011
Last updated
01/28/2025
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