Provider Demographics
NPI:1851693402
Name:SPRADLEY, BONNIE ROSE (RN, BSN, CNOR, RNFA)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:ROSE
Last Name:SPRADLEY
Suffix:
Gender:F
Credentials:RN, BSN, CNOR, RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:876 DRESSLERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:GARDNERVILLE
Mailing Address - State:NV
Mailing Address - Zip Code:89460-8927
Mailing Address - Country:US
Mailing Address - Phone:775-265-3108
Mailing Address - Fax:775-265-9657
Practice Address - Street 1:876 DRESSLERVILLE RD
Practice Address - Street 2:
Practice Address - City:GARDNERVILLE
Practice Address - State:NV
Practice Address - Zip Code:89460-8927
Practice Address - Country:US
Practice Address - Phone:775-265-3108
Practice Address - Fax:775-265-9657
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN27765163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant