Individual
STEPHANIE BONILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5983 S REDWOOD RD, TAYLORSVILLE, UT 84123-5261
(385) 800-3015
Mailing address
5983 S REDWOOD RD, TAYLORSVILLE, UT 84123-5261
(805) 200-1406
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
130147473101
UT
Other
Enumeration date
08/16/2023
Last updated
01/09/2025
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