Individual
SARAH BONASSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
101 TYGART MALL LOOP STE 102A, FAIRMONT, WV 26554-2972
(304) 599-8000
(304) 599-8003
Mailing address
1247 SUNCREST TOWN CENTRE DR, MORGANTOWN, WV 26505-1876
(304) 599-8000
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
85838
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85838
WV BOARD OF EXAMINERS FOR REGISTERED PROFESSIONAL NURSES
WV
Enumeration date
09/10/2018
Last updated
04/12/2022
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