Individual
MRS. JESSICA JEAN BONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-8000
Mailing address
PO BOX 603949, CHARLOTTE, NC 28260-3949
(919) 350-2266
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5020127
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952166910
—
NC
Enumeration date
02/19/2024
Last updated
10/10/2024
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