Provider Demographics
NPI:1154320778
Name:NEFF, BONNIE (NP)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:
Last Name:NEFF
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 1:13421 OLD MERIDIAN ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-1427
Mailing Address - Country:US
Mailing Address - Phone:317-815-8950
Mailing Address - Fax:317-815-8951
Practice Address - Street 1:13421 OLD MERIDIAN ST
Practice Address - Street 2:SUITE 205
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-1427
Practice Address - Country:US
Practice Address - Phone:317-815-8950
Practice Address - Fax:317-815-8951
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000084A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P35151Medicare UPIN
223960CMedicare ID - Type Unspecified