Provider Demographics
NPI:1235189226
Name:JAMES, BONNIE FREID (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:FREID
Last Name:JAMES
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:9300 DEWITT LOOP
Mailing Address - Street 2:VA MEDICAL CLINIC
Mailing Address - City:FT BELVOIR
Mailing Address - State:VA
Mailing Address - Zip Code:22060-5285
Mailing Address - Country:US
Mailing Address - Phone:571-231-2408
Mailing Address - Fax:
Practice Address - Street 1:9300 DEWITT LOOP
Practice Address - Street 2:VA MEDICAL CLINIC
Practice Address - City:FT BELVOIR
Practice Address - State:VA
Practice Address - Zip Code:22060-5285
Practice Address - Country:US
Practice Address - Phone:571-231-2408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2012-03-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0110000778363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical