Provider Demographics
NPI:1497293153
Name:EAST, BONNIE
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:EAST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8511 AUGUSTA DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68526-9572
Mailing Address - Country:US
Mailing Address - Phone:402-934-3886
Mailing Address - Fax:402-506-5254
Practice Address - Street 1:8511 AUGUSTA DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68526-9572
Practice Address - Country:US
Practice Address - Phone:402-934-3886
Practice Address - Fax:402-506-5254
Is Sole Proprietor?:No
Enumeration Date:2017-02-02
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-03266363LF0000X
NE113335363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily