Servage, Bonnie L
Servage, Bonnie L is an individual health care provider with primary practice located at 53-59 Public Sq Ste 301, Watertown NY 13601-2674. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Servage, Bonnie L can be contacted via phone (315) 782-2141.Contact Information
Primary practice address
53-59 Public Sq Ste 301
Watertown NY 13601-2674
Phone: (315) 782-2141
Fax: (315) 782-5123
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | F303309 | New York |
Profile Details
| NPI number | 1093718066 |
|---|---|
| LBN Legal business name | Servage, Bonnie L |
| Credentials | Adult Nurse Practitioner (ANP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 24th, 2005 |
| Last updated | Oct 25th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093718066 | NPPES |
| New York | MEDICAID | 02331175 | |
| New York | Other | 7599474 |
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