Individual
BONNIE DORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
101 REGENT CT, STATE COLLEGE, PA 16801-7965
(814) 231-2102
Mailing address
259 FISHING CREEK RD, MILL HALL, PA 17751-9129
(814) 861-2177
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
RN173587L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
157063
HEALTH AMERICA
PA
01
—
31588991B
GEISINGER HEALTH PLAN
PA
01
—
50034874
CAPITAL BLUECROSS
PA
01
—
P00146203
RAILROAD MEDICARE
PA
01
—
RN173587L
RN LICENSE NUMBER
PA
Enumeration date
10/02/2006
Last updated
07/08/2007
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