Nothern, Bonny C

Nothern, Bonny C is an individual health care provider with primary practice located at 45 Dimock St , Roxbury MA 02119-1208. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Nothern, Bonny C can be contacted via phone (617) 442-8800.

Contact Information

Primary practice address
45 Dimock St Roxbury MA 02119-1208
Phone: (617) 442-8800
Fax: (617) 541-8472
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN236176 Massachusetts
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X MA236176 Massachusetts
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X RN236176 Massachusetts

Profile Details

NPI number 1538194865
LBN Legal business name Nothern, Bonny C
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2006
Last updated May 28th, 2021 - about 3 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 1538194865 NPPES
Massachusetts MEDICAID NP472601

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