Smith, Bonnie Kellam
Smith, Bonnie Kellam is an individual health care provider with primary practice located at 4600 Gulf Fwy , Houston TX 77023-3548. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Women's Health, Nursing Service Providers / Registered Nurse. Physician Assistants & Advanced Practice Nursing Providers / Women's Health is her primary health care specialty. Smith, Bonnie Kellam can be contacted via phone (713) 522-3976.Contact Information
Primary practice address
4600 Gulf Fwy
Houston TX 77023-3548
Phone: (713) 522-3976
Fax: (404) 494-7435
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Women's Health | 363LW0102X | AP103014 | Texas |
Nursing Service Providers / Registered Nurse | 163W00000X | RN452065 | Texas |
Nursing Service Providers / Registered Nurse | 163W00000X | RN112114 | Louisiana |
Physician Assistants & Advanced Practice Nursing Providers / Women's Health | 363LW0102X | AP04701 | Louisiana |
Profile Details
NPI number | 1053518894 |
---|---|
LBN Legal business name | Smith, Bonnie Kellam |
Credentials | WHCNP |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 27th, 2007 |
Last updated | Sep 13th, 2019 - 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1053518894 | NPPES |
Louisiana | MEDICAID | 1815365 | |
Louisiana | MEDICAID | 0708125-03 |
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