Provider Demographics
NPI:1821507112
Name:LEDFORD, BONNIE (CNM, APRN)
Entity type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:
Last Name:LEDFORD
Suffix:
Gender:F
Credentials:CNM, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:ALLEGANY
Mailing Address - State:NY
Mailing Address - Zip Code:14706-1109
Mailing Address - Country:US
Mailing Address - Phone:716-201-0875
Mailing Address - Fax:
Practice Address - Street 1:121 MARKET ST
Practice Address - Street 2:
Practice Address - City:POTSDAM
Practice Address - State:NY
Practice Address - Zip Code:13676-1716
Practice Address - Country:US
Practice Address - Phone:520-331-8973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-29
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF002240-01367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife