Individual provider · NPI-1

Kristie Michelle Bonot, PA - C

Physician Assistant · Wilson, NC

NPI number1922347749
StatusActive
Last updated in NPPESJan 19, 2024

Details

NPI
1922347749
Entity type
Individual (NPI-1)
Name
Kristie Michelle Bonot
Credential
PA - C
Sex
Female
Sole proprietor
Yes
Enumeration date
Feb 14, 2013
Certification date
Jan 19, 2024
Last updated
Jan 19, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant0010-04103NCYes

Practice location

2503 Forest Hills Rd W Ste B
Wilson, NC 27893-3392

Phone 252-991-0555

Mailing address

2503 Forest Hills Rd W Ste B
Wilson, NC 27893-3392

Phone 252-991-0555

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