Nicole Bonar, CRNP
Nurse Practitioner, Family in Austin, TX. Individual provider (NPI-1).
NPI number1407471154
StatusActive
Last updated in NPPESJun 9, 2020
Details
- NPI
- 1407471154
- Entity type
- Individual (NPI-1)
- Name
- Nicole Bonar
- Credential
- CRNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 9, 2020
- Certification date
- Jun 9, 2020
- Last updated
- Jun 9, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | AP144520 | TX | Yes |
| 163W00000X | Registered Nurse | 870829 | TX | |
| 163WF0300X | Registered Nurse, Flight | 7003754 | TX |
Practice location
2911 Medical Arts St Ste 10Austin, TX 78705-3302
Phone 866-473-0663
Mailing address
1006 Home Depot Way Apt 5109Bastrop, TX 78602-2974
Phone 256-565-2431
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