Bonner, Eddie Amos

Bonner, Eddie Amos is an individual health care provider with primary practice located at 120 E Harris Ave , San Angelo TX 76903-5904. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Bonner, Eddie Amos can be contacted via phone (325) 657-5028.

Contact Information

Primary practice address
120 E Harris Ave San Angelo TX 76903-5904
Phone: (325) 657-5028
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 680179 Texas

Profile Details

NPI number 1396045241
LBN Legal business name Bonner, Eddie Amos
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2010
Last updated Jun 17th, 2011 - about 14 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 1396045241 NPPES
Texas Other 838N75 BCBS

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