Individual
BRITTANI D BONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3235 BRIDGE RD STE 15, SUFFOLK, VA 23435-1780
(757) 606-1656
(757) 606-1657
Mailing address
3235 BRIDGE RD STE 15, SUFFOLK, VA 23435-1780
(757) 606-1656
(757) 606-1657
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-04003
NC
363A00000X
Physician Assistant
Primary
0110008551
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-04003
NC MEDCIAL BOARD LICENSE
NC
Enumeration date
02/11/2013
Last updated
08/25/2023
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