Provider Demographics
NPI:1083125488
Name:BONNER, HOLLY LYN (MPH, PA-C)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:LYN
Last Name:BONNER
Suffix:
Gender:F
Credentials:MPH, PA-C
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Mailing Address - Street 1:11281 WEATHERSTONE DR
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:PA
Mailing Address - Zip Code:17268-8837
Mailing Address - Country:US
Mailing Address - Phone:301-697-9918
Mailing Address - Fax:
Practice Address - Street 1:510 BUTLER AVE
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25405-9990
Practice Address - Country:US
Practice Address - Phone:304-263-0811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-12
Last Update Date:2024-03-21
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant