Dr NICOLE R BONNER is a female medical professional, specializing in Nurse Practitioner. She graduated in 2008 from West Virginia University School Of Medicine.
MEP OBSERVATION SERVICES LLC
5401 OLD COURT RD
RANDALLSTOWN
MD
211335103
Tel: 4105212200
| Npi | 1770733248 |
| Pac Id | 1456538297 |
| Professional Enrollment Id | I20110606000089 |
| Last Name | BONNER |
| First Name | NICOLE |
| Middle Name | R |
| Suffix | |
| Gender | F |
| Credential | |
| Medical School Name | WEST VIRGINIA UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2008 |
| Primary Specialty | NURSE PRACTITIONER |
| Secondary Specialty 1 | |
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| Organization Legal Name | MEP OBSERVATION SERVICES LLC |
| Group Practice Pac Id | 2365611845 |
| Number Of Group Practice Members | 52 |
| Line 1 Street Address | 5401 OLD COURT RD |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | |
| City | RANDALLSTOWN |
| State | MD |
| Zip Code | 211335103 |
| Phone Number | 4105212200 |
| Hospital Affiliation Ccn 1 | 210027 |
| Hospital Affiliation Lbn 1 | WESTERN MARYLAND REGIONAL MEDICAL CENTER |
| Hospital Affiliation Ccn 2 | |
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| Professional Accepts Medicare Assignment | Y |
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