Provider Demographics
NPI:1932144987
Name:KNOX, BONNIE JEAN (CRNA)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:JEAN
Last Name:KNOX
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 PARISH BLVD
Mailing Address - Street 2:
Mailing Address - City:MARY ESTHER
Mailing Address - State:FL
Mailing Address - Zip Code:32569-1478
Mailing Address - Country:US
Mailing Address - Phone:850-499-8093
Mailing Address - Fax:
Practice Address - Street 1:520 PARISH BLVD
Practice Address - Street 2:
Practice Address - City:MARY ESTHER
Practice Address - State:FL
Practice Address - Zip Code:32569-1478
Practice Address - Country:US
Practice Address - Phone:850-499-8093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9190858367500000X
MA262607367500000X
TX575156367500000X
AL1-097300367500000X
MSR856839367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered