Provider Demographics
NPI:1831656644
Name:CARTWRIGHT-THORNTON, BONITA (PMHNP-BC, CRNP)
Entity Type:Individual
Prefix:
First Name:BONITA
Middle Name:
Last Name:CARTWRIGHT-THORNTON
Suffix:
Gender:F
Credentials:PMHNP-BC, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3104 LORD BALTIMORE DR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2898
Mailing Address - Country:US
Mailing Address - Phone:410-281-7801
Mailing Address - Fax:
Practice Address - Street 1:3104 LORD BALTIMORE DR
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-2898
Practice Address - Country:US
Practice Address - Phone:410-281-7801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR050671363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health