Individual
BONNIE SCANLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
406 FRANKLIN ST, SMETHPORT, PA 16749-1277
(814) 887-5655
Mailing address
908 NIAGARA FALLS BLVD STE 208, NORTH TONAWANDA, NY 14120-2019
(716) 692-3302
(716) 692-4342
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
TP000633B
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04217983
—
NY
05
—
1027766530001
—
PA
05
—
1027766530002
—
PA
05
—
1027766530003
—
PA
Enumeration date
05/26/2006
Last updated
02/04/2020
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