Provider Demographics
NPI:1356169411
Name:WORKMAN, BONNIE LEE
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:LEE
Last Name:WORKMAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1606 CARMODY CT STE 202
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-8566
Mailing Address - Country:US
Mailing Address - Phone:724-933-1500
Mailing Address - Fax:
Practice Address - Street 1:1606 CARMODY CT STE 202
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-8566
Practice Address - Country:US
Practice Address - Phone:724-933-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-27
Last Update Date:2025-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA066047363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty