Individual
ELIZABETH RENEE BONIFAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
750 W HIGH ST, LIMA, OH 45801-2969
(419) 229-6781
Mailing address
10377 CHENOWITH RD, VAN WERT, OH 45891-9058
(567) 204-4208
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.359828
OH
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.0028654
OH
Other
Enumeration date
01/06/2022
Last updated
01/25/2022
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