Individual
WILLIAM C BONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(978) 618-4803
Mailing address
55 FRUIT ST, BOSTON, MA 02114-2621
(978) 618-4803
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN283895
MA
363LA2200X
Adult Health Nurse Practitioner
307535
NY
Other
Enumeration date
10/22/2013
Last updated
12/16/2024
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