Provider Demographics
NPI:1851190722
Name:BONILLA, ANA CAROLYN (MSN, FNP-C)
Entity type:Individual
Prefix:MISS
First Name:ANA
Middle Name:CAROLYN
Last Name:BONILLA
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:6500 ARIA BLVD APT 565
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-3684
Mailing Address - Country:US
Mailing Address - Phone:507-316-2896
Mailing Address - Fax:
Practice Address - Street 1:4684 ROSWELL RD STE B
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-3074
Practice Address - Country:US
Practice Address - Phone:404-367-9005
Practice Address - Fax:678-240-4188
Is Sole Proprietor?:No
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGAA-NP002555363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily