Doctor Name: | BONNIE J ROBERTSON |
NPI Number: | 1013931757 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | C.R.N.P |
License Number: | APN 0000012089 |
Business Practice Address: | 500 Governors Dr Sw Huntsville, AL - 358015126 |
Business Phone Number: | 2565189998 |
Business Fax Number: | 2565189941 |
Mailing Address: | 500 Governors Dr Sw, HUNTSVILLE |
State: | AL |
Postal Code: | 358015126 |
Phone Number: | 2565189998 |
Fax Number: | 2565189941 |
NPI Enumeration Date: | 07/26/2006 |
NPI Last Update Date: | 12/16/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | APN 0000012089 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |