Bonaccorsi, Mary T.

Bonaccorsi, Mary T. is an individual health care provider with primary practice located at 903 Mineral Point Ave , Janesville WI 53548-2970. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Bonaccorsi, Mary T. can be contacted via phone (608) 756-5555.

Contact Information

Primary practice address
903 Mineral Point Ave Janesville WI 53548-2970
Phone: (608) 756-5555
Fax: (608) 756-0174
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209004213 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 2628-033 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 2628-33 Wisconsin

Profile Details

NPI number 1811927205
LBN Legal business name Bonaccorsi, Mary T.
Credentials APRN, DNP, FNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2006
Last updated Jul 21st, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811927205 NPPES
Wisconsin Other 1811927205 BCBSWI
Wisconsin Other 000054176-K400333954 BCBSWI
Wisconsin Other 000084908-K400332994 BCBSWI
Wisconsin MEDICAID 1811927205 BCBSWI
Wisconsin Other BONACMAR BCBSWI
Wisconsin MEDICAID 041305302 BCBSWI
Wisconsin Other 406120105 BCBSWI

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