Provider Demographics
NPI:1710366711
Name:BONSIGNORE, ELIZABETH (RN LMT)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:BONSIGNORE
Suffix:
Gender:F
Credentials:RN LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 STURDEVANT RD
Mailing Address - Street 2:
Mailing Address - City:GILLETT
Mailing Address - State:PA
Mailing Address - Zip Code:16925-9041
Mailing Address - Country:US
Mailing Address - Phone:570-596-4555
Mailing Address - Fax:
Practice Address - Street 1:815 STURDEVANT RD
Practice Address - Street 2:
Practice Address - City:GILLETT
Practice Address - State:PA
Practice Address - Zip Code:16925-9041
Practice Address - Country:US
Practice Address - Phone:570-596-4555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-22
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY439051-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse