Provider Demographics
NPI:1467643114
Name:BONNEY, JANET LEIGH (LPN)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:LEIGH
Last Name:BONNEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1998
Mailing Address - Street 2:
Mailing Address - City:CEDAR BLUFF
Mailing Address - State:IA
Mailing Address - Zip Code:24609
Mailing Address - Country:US
Mailing Address - Phone:276-963-7555
Mailing Address - Fax:
Practice Address - Street 1:111 TOWN HOLLOW RD
Practice Address - Street 2:CLINCH VALLEY TREATMENT CENTER
Practice Address - City:CEDAR BLUFF
Practice Address - State:IN
Practice Address - Zip Code:24609
Practice Address - Country:US
Practice Address - Phone:276-963-3554
Practice Address - Fax:276-963-3544
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002061288164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse