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Individual

BONNIE E DANIEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
8159 NORTHUMBERLAND HWY, HEATHSVILLE, VA 22473
(804) 580-7200
Mailing address
PO BOX 2255, KILMARNOCK, VA 22482-2255

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024157970
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
500017495
RR MEDICARE
VA
Enumeration date
08/04/2006
Last updated
11/18/2010
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