Individual
JESSIE BONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2334 WASHINGTON ST, ALEXANDER CITY, AL 35010-3569
(337) 991-9276
Mailing address
1509 DULLES DR, LAFAYETTE, LA 70506-3718
(337) 991-9276
(337) 943-0846
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-130459
AL
Other
Enumeration date
08/12/2019
Last updated
08/12/2019
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