Provider Demographics
NPI:1518545334
Name:BOND, JOHNEL
Entity Type:Individual
Prefix:
First Name:JOHNEL
Middle Name:
Last Name:BOND
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 1:6 MAUPIN CT
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23702-1024
Mailing Address - Country:US
Mailing Address - Phone:757-362-2165
Mailing Address - Fax:
Practice Address - Street 1:6 MAUPIN CT
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23702-1024
Practice Address - Country:US
Practice Address - Phone:757-362-2165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-01
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAHCO232794Medicaid