Provider Demographics
NPI:1093309932
Name:SILVIS, BONNIE L
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:L
Last Name:SILVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11315 SMOKY ROW RD
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45121-8829
Mailing Address - Country:US
Mailing Address - Phone:513-532-6197
Mailing Address - Fax:
Practice Address - Street 1:11156 SMOKY ROW RD
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:OH
Practice Address - Zip Code:45121-8214
Practice Address - Country:US
Practice Address - Phone:513-532-6197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3128412374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide