Individual
BONITA FAITH JAIME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
11659 N LOOP DR, SOCORRO, TX 79927-4508
(915) 216-8903
Mailing address
11659 N LOOP DR, SOCORRO, TX 79927-4508
(915) 216-8903
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
962248
TX
Other
Enumeration date
06/13/2019
Last updated
06/13/2019
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