Provider Demographics
NPI:1518704592
Name:NIENKARK, BOBBIE LONA (ARNP AGPCNP)
Entity type:Individual
Prefix:MISS
First Name:BOBBIE
Middle Name:LONA
Last Name:NIENKARK
Suffix:
Gender:F
Credentials:ARNP AGPCNP
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Mailing Address - Street 1:9400 N NAME UNO
Mailing Address - Street 2:
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020-3528
Mailing Address - Country:US
Mailing Address - Phone:408-848-8680
Mailing Address - Fax:
Practice Address - Street 1:9400 N NAME UNO
Practice Address - Street 2:
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-3528
Practice Address - Country:US
Practice Address - Phone:408-848-8680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IAAG05240088363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health