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Individual

MRS. KATHLEEN BONIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
42 TOWN ST STE 300, NORWICH, CT 06360-2339
(860) 886-0567
(860) 886-0567
Mailing address
42 TOWN ST STE 300, NORWICH, CT 06360-2339
(860) 886-0567
(860) 886-0567

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
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