Individual
HEATHER ELIZABETH BONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(215) 590-1000
Mailing address
1500 LOCUST ST APT 2420, PHILADELPHIA, PA 19102-4319
(262) 366-3029
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
SP020607
PA
363LP0200X
Pediatric Nurse Practitioner
Primary
SP020607
PA
Other
Enumeration date
09/12/2019
Last updated
09/12/2019
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