Tashara C Bonham, LPN
Licensed Practical Nurse in Rochester, NY. Individual provider (NPI-1).
NPI number1407096563
StatusActive
Last updated in NPPESMar 3, 2009
Details
- NPI
- 1407096563
- Entity type
- Individual (NPI-1)
- Name
- Ms. Tashara C Bonham
- Credential
- LPN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 3, 2009
- Last updated
- Mar 3, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | 296301 | NY | Yes |
Practice location
375 Hawley StRochester, NY 14611-3609
Phone 585-509-9317
Mailing address
375 Hawley StRochester, NY 14611-3609
Phone 585-509-9317
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