Provider Demographics
NPI:1689725798
Name:FRENCH, BONNIE J (APRN)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:J
Last Name:FRENCH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:BONNIE
Other - Middle Name:
Other - Last Name:FRENCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:320 JOAN AVE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-2242
Mailing Address - Country:US
Mailing Address - Phone:270-769-3714
Mailing Address - Fax:270-769-0335
Practice Address - Street 1:320 JOAN AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2242
Practice Address - Country:US
Practice Address - Phone:270-769-3714
Practice Address - Fax:270-769-0335
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3002236364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP400017232Medicare PIN