Individual
BONNIE EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1900 GENESEE ST, UTICA, NY 13502-5635
(315) 797-7050
Mailing address
9412 HAMILTON ST, CHADWICKS, NY 13319-3529
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
204416
NY
Other
Enumeration date
02/09/2007
Last updated
07/08/2007
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