Carly Bonner, LAT, ATC
Student in an Organized Health Care Education/Training Program in Laurel, MD. Individual provider (NPI-1).
Details
- NPI
- 1174006753
- Entity type
- Individual (NPI-1)
- Name
- Carly Bonner
- Credential
- LAT, ATC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 10, 2018
- Certification date
- Mar 23, 2021
- Last updated
- Sep 11, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
14700 Baltimore Ave Unit 106Laurel, MD 20707-4878
Phone 267-535-0473
Mailing address
6926 10 Timbers LnBaltimore, MD 21209-1637
Phone 267-535-0473
Other practice locations
Towson, MD 21204-7450
Phone 410-704-2000
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 18 Student in an Organized Health Care Education/Training Program providers in Laurel · All 3,583 providers in Laurel
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