Individual provider · NPI-1

Shavonne Renee Bonner, FNP

Nurse Practitioner, Family · Fort Worth, TX

NPI number1669360079

StatusActive

Last updated in NPPESSep 25, 2025

Details

NPI: 1669360079
Entity type: Individual (NPI-1)
Name: Shavonne Renee Bonner
Credential: FNP
Sex: Female
Sole proprietor: No
Enumeration date: Jun 25, 2025
Certification date: Sep 25, 2025
Last updated: Sep 25, 2025

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
363LF0000X	Nurse Practitioner, Family	1143304	TX	Yes
163WG0000X	Registered Nurse, General Practice	1143304	TX

Other names

Shavonne Renee Faust (Former Name)

Practice location

3800 N Tarrant Pkwy Ste 210
Fort Worth, TX 76244-5416

Phone 682-593-6660

Mailing address

913 Superbloom Ave
Justin, TX 76247-2093

Phone 312-890-6483

Other practice locations

8712 Medical City Way
Fort Worth, TX 76177-2414

Phone 817-900-3000

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