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Individual

CHARLENE BONNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP-C, PMHNP-BC

Contact information

Practice address
1288 MILL CREEK CV, MEMPHIS, TN 38134-7820
(865) 246-2104
(865) 246-2106
Mailing address
PO BOX 5777, MARYVILLE, TN 37802-5777
(865) 246-2104
(865) 246-2106

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
19617
TN
363LF0000X
Family Nurse Practitioner
345905
NY
363LF0000X
Family Nurse Practitioner
AP127855
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
404725
NY

Other

Enumeration date
01/26/2015
Last updated
04/25/2023
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