Provider Demographics
NPI:1841686938
Name:BONITO, NANCI ANN (RN)
Entity type:Individual
Prefix:MS
First Name:NANCI
Middle Name:ANN
Last Name:BONITO
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 1:123 WATERHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:BOURNE
Mailing Address - State:MA
Mailing Address - Zip Code:02532-3890
Mailing Address - Country:US
Mailing Address - Phone:508-759-7920
Mailing Address - Fax:
Practice Address - Street 1:123 WATERHOUSE RD
Practice Address - Street 2:
Practice Address - City:BOURNE
Practice Address - State:MA
Practice Address - Zip Code:02532-3890
Practice Address - Country:US
Practice Address - Phone:508-759-7920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-15
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2280304163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)