Provider Demographics
NPI:1508008723
Name:CHOI, BONNIE K (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:K
Last Name:CHOI
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:MRS
Other - First Name:BONNIE
Other - Middle Name:
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:34TH STREET AND CIVIC CENTER BOULEVARD
Mailing Address - Street 2:WOOD BUILDING, 1ST FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:215-590-3440
Mailing Address - Fax:215-590-3986
Practice Address - Street 1:3500 CIVIC CENTER BOULEVARD
Practice Address - Street 2:5TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-590-3440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-02
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN533464163WP0200X
PASP010106363LP0200X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics