Provider Demographics
NPI:1982376059
Name:BONAS, ANDREA RUTH (NP-C)
Entity Type:Individual
Prefix:MISS
First Name:ANDREA
Middle Name:RUTH
Last Name:BONAS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:455 TOLL GATE RD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2759
Mailing Address - Country:US
Mailing Address - Phone:401-273-0641
Mailing Address - Fax:401-273-2919
Practice Address - Street 1:101 DUDLEY ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-2401
Practice Address - Country:US
Practice Address - Phone:401-453-7520
Practice Address - Fax:401-453-7529
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-28
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIAPRN02818363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily