Provider Demographics
NPI:1295085066
Name:ROBBINS, BONITA MARY (RN)
Entity type:Individual
Prefix:
First Name:BONITA
Middle Name:MARY
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 PRE-EMPTION ST
Mailing Address - Street 2:SIBLEY NURSING
Mailing Address - City:GENEVA
Mailing Address - State:NY
Mailing Address - Zip Code:14456
Mailing Address - Country:US
Mailing Address - Phone:315-781-0863
Mailing Address - Fax:315-781-5447
Practice Address - Street 1:590 PRE EMPTION RD
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:NY
Practice Address - Zip Code:14456-1372
Practice Address - Country:US
Practice Address - Phone:315-781-0863
Practice Address - Fax:315-781-5447
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY451145-1163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health