Provider Demographics
NPI:1083981427
Name:SANTMYER, BONNIE LOU (RN)
Entity Type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:LOU
Last Name:SANTMYER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1351 STATE ROUTE 31
Mailing Address - Street 2:
Mailing Address - City:MACEDON
Mailing Address - State:NY
Mailing Address - Zip Code:14502-9104
Mailing Address - Country:US
Mailing Address - Phone:315-986-4847
Mailing Address - Fax:
Practice Address - Street 1:1351 STATE ROUTE 31
Practice Address - Street 2:
Practice Address - City:MACEDON
Practice Address - State:NY
Practice Address - Zip Code:14502-9104
Practice Address - Country:US
Practice Address - Phone:315-986-4847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-30
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ180050-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse