Individual
CARIE ELISE BODNAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ACNPC-AG
Contact information
Practice address
910 E HOUSTON ST STE 500, TYLER, TX 75702-8365
(757) 692-7703
Mailing address
17152 LAKESIDE DR, FLINT, TX 75762-9237
(757) 692-7703
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1005219
TX
Other
Enumeration date
07/29/2020
Last updated
07/29/2020
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