Provider Demographics
NPI:1275094963
Name:CAPOSSELA, BONNE LYNN (NP-C)
Entity Type:Individual
Prefix:MS
First Name:BONNE
Middle Name:LYNN
Last Name:CAPOSSELA
Suffix:
Gender:F
Credentials:NP-C
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Other - Credentials:
Mailing Address - Street 1:10228 W COGGINS DR STE 1
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-3421
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10228 W COGGINS DR STE 1
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3421
Practice Address - Country:US
Practice Address - Phone:623-214-8800
Practice Address - Fax:623-214-3446
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ226706363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner