Individual
MRS. KATHLEEN BONIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
002975
CT
363LP2300X
Primary Care Nurse Practitioner
Primary
002975
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004242848
—
CT
01
—
102975
CONNECTICARE
CT
01
—
2V4906
HEALTH NET
CT
01
—
400002975CT01
ANTHEM BLUE CROSS
CT
01
—
P3245483
OXFORD
CT
Enumeration date
10/21/2005
Last updated
01/10/2023
Update your record
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