Individual
BONITA G WARDLE ROCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
100 NEW SALEM RD, UNIONTOWN, PA 15401-8936
(724) 437-0729
(724) 437-2761
Mailing address
100 NEW SALEM RD, UNIONTOWN, PA 15401-8936
(724) 437-0729
(724) 437-2761
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
VP000164F
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1009799060001
—
PA
Enumeration date
11/06/2006
Last updated
07/08/2007
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