Individual
DIANE MARIE BONIFAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
10029 BOCKEY RD, DELPHOS, OH 45833-8832
(419) 692-0063
Mailing address
10029 BOCKEY RD, DELPHOS, OH 45833-8832
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
209362
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209362
RN
OH
Enumeration date
06/09/2021
Last updated
06/09/2021
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