Provider Demographics
NPI:1407806276
Name:ELKHAIR, BONNIE BELLE (NP)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:BELLE
Last Name:ELKHAIR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:BONNIE
Other - Middle Name:BELLE
Other - Last Name:MCDOWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:501 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74003-3910
Mailing Address - Country:US
Mailing Address - Phone:918-336-0823
Mailing Address - Fax:918-336-0931
Practice Address - Street 1:501 E 5TH ST
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74003-3910
Practice Address - Country:US
Practice Address - Phone:918-336-0823
Practice Address - Fax:918-336-0931
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0041003363LF0000X
AZRN106738 AP1684363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1741003Medicaid
OKP83528Medicare UPIN