Individual
MS. BETH A BONIFAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
984 FIRST COLONIAL RD STE 302, VIRGINIA BEACH, VA 23454-3196
(757) 481-0385
Mailing address
984 FIRST COLONIAL RD STE 302, VIRGINIA BEACH, VA 23454-3196
(757) 481-0385
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0017136969
VA
363LP0200X
Pediatric Nurse Practitioner
0017136969
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010418071
—
VA
01
—
012862C41
MEDICARE
VA
05
—
7003969
—
NC
Enumeration date
01/05/2007
Last updated
07/27/2025
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