Provider Demographics
NPI:1033527080
Name:BONNETT, JANICE (NP)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:BONNETT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 E UNIVERSITY DR
Mailing Address - Street 2:SUITE 6
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85203-8237
Mailing Address - Country:US
Mailing Address - Phone:480-246-3560
Mailing Address - Fax:
Practice Address - Street 1:1840 E UNIVERSITY DR
Practice Address - Street 2:SUITE 6
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-8237
Practice Address - Country:US
Practice Address - Phone:480-246-3560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-22
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP0278163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health