Provider Demographics
NPI:1497151138
Name:BEARD, BONNIE (RN)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:BEARD
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 1:16347 E PHILLIPS LN
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-4609
Mailing Address - Country:US
Mailing Address - Phone:720-329-2292
Mailing Address - Fax:
Practice Address - Street 1:16347 E PHILLIPS LN
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-4609
Practice Address - Country:US
Practice Address - Phone:720-329-2292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-07
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1625510163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health