Rae, Bonnie

Rae, Bonnie is an individual health care provider with primary practice located at 170 Morton St , Jamaica Plain MA 02130-3735. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Rae, Bonnie can be contacted via phone (617) 971-3961.

Contact Information

Primary practice address
170 Morton St Jamaica Plain MA 02130-3735
Phone: (617) 971-3961
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 101-0022621 Vermont
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 214532 Massachusetts

Profile Details

NPI number 1619049756
LBN Legal business name Rae, Bonnie
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 14th, 2006
Last updated Nov 8th, 2012 - about 13 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 1619049756 NPPES
Vermont Other 101-0022621 LICENSE
Vermont Other NP214532 LICENSE

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