Provider Demographics
NPI:1447424205
Name:BONYAK, KAY (NP)
Entity Type:Individual
Prefix:MRS
First Name:KAY
Middle Name:
Last Name:BONYAK
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 1:125 MEDICAL CIR STE A
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-3300
Mailing Address - Country:US
Mailing Address - Phone:540-667-1828
Mailing Address - Fax:540-722-3658
Practice Address - Street 1:125 MEDICAL CIR STE A
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3300
Practice Address - Country:US
Practice Address - Phone:540-667-1828
Practice Address - Fax:540-722-3658
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167774363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care