Provider Demographics
NPI:1275219404
Name:DUNTON, BONNIE G (RN)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:G
Last Name:DUNTON
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 1:2458 SHAW MILL RD
Mailing Address - Street 2:
Mailing Address - City:SAINT PAULS
Mailing Address - State:NC
Mailing Address - Zip Code:28384-8502
Mailing Address - Country:US
Mailing Address - Phone:910-633-9910
Mailing Address - Fax:
Practice Address - Street 1:2458 SHAW MILL RD
Practice Address - Street 2:
Practice Address - City:SAINT PAULS
Practice Address - State:NC
Practice Address - Zip Code:28384-8502
Practice Address - Country:US
Practice Address - Phone:910-633-9910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC106828163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse