Provider Demographics
NPI:1265781298
Name:BONIN-OMONIYI, CYNTHIA OLUYEMI LAKIA (DNP, FNP-C, APRN)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:OLUYEMI LAKIA
Last Name:BONIN-OMONIYI
Suffix:
Gender:F
Credentials:DNP, FNP-C, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 CORYELL CITY RD
Mailing Address - Street 2:
Mailing Address - City:GATESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76528-2913
Mailing Address - Country:US
Mailing Address - Phone:409-772-1011
Mailing Address - Fax:
Practice Address - Street 1:1210 CORYELL CITY RD
Practice Address - Street 2:
Practice Address - City:GATESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76528-2913
Practice Address - Country:US
Practice Address - Phone:409-772-1011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX761411363LF0000X
TXAP121104363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily