Provider Demographics
NPI:1457169062
Name:BONELLA, BRIANNA DANAEE (FNP)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:DANAEE
Last Name:BONELLA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 GRAND VIEW CIR
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-4885
Mailing Address - Country:US
Mailing Address - Phone:970-852-2853
Mailing Address - Fax:
Practice Address - Street 1:2801 GRAND VIEW CIR
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-4885
Practice Address - Country:US
Practice Address - Phone:970-852-2853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-28
Last Update Date:2024-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.1000382-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily