Individual
LINDSAY B BONAVENTURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1033 N INDIANA AVE, SYRACUSE, IN 46567-1017
(574) 457-5701
(574) 457-5609
Mailing address
PO BOX 834, GOSHEN, IN 46527-0834
(574) 364-2592
(574) 364-2759
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71004237A
IN
363LF0000X
Family Nurse Practitioner
Primary
71004237A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71004237A
LICENSE
IN
Enumeration date
11/15/2012
Last updated
07/30/2024
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