O'Reilly, Bonita J

O'Reilly, Bonita J is an sole proprietor health care provider with primary practice located at 8191 Moorsbridge Rd Ste A , Portage MI 49024-7417. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. O'Reilly, Bonita J can be contacted via phone (269) 312-8170.

Contact Information

Primary practice address
8191 Moorsbridge Rd Ste A Portage MI 49024-7417
Phone: (269) 312-8170
Fax: (269) 762-4785
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 47-04-102421 Michigan

Profile Details

NPI number 1255333860
LBN Legal business name O'Reilly, Bonita J
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 12th, 2005
Last updated Mar 17th, 2018 - about 6 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 1255333860 NPPES
Michigan MEDICAID 104545483
Michigan MEDICAID 104545456
Michigan MEDICAID 104545492
Michigan MEDICAID 104545465

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