Individual
NICOLE R BONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP-F
Contact information
Practice address
10701 NEW GEORGES CREEK RD SW, FROSTBURG, MD 21532-1457
(301) 689-3229
(301) 689-1129
Mailing address
625 KENT AVE STE 107, CUMBERLAND, MD 21502-3798
(240) 964-4887
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R167886
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
216981ZFT6
PTAN
MD
Enumeration date
09/22/2008
Last updated
05/11/2019
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