Provider Demographics
NPI:1881802064
Name:YOPP, BONNIE ANN (ANP)
Entity type:Individual
Prefix:MISS
First Name:BONNIE
Middle Name:ANN
Last Name:YOPP
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 SALMON RIVER RD
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-7631
Mailing Address - Country:US
Mailing Address - Phone:518-563-7129
Mailing Address - Fax:518-561-2849
Practice Address - Street 1:450 SALMON RIVER RD
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-7631
Practice Address - Country:US
Practice Address - Phone:518-563-7129
Practice Address - Fax:518-561-2849
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF-301509-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
141603303OtherTRICARE
500021522OtherGBA RAILROAD PROVIDER
141603303OtherTRICARE