National Provider Identifier

Bonnie J Clark, LPN

Bonnie J Clark, LPN is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Corning, NY and a listed phone number of (607) 937-4385.

NPI 1104173822Corning, NYLicensed Practical Nurse

Profile Overview

NPI
1104173822
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
August 13, 2012
Last Updated
August 13, 2012

Practice Location

  • 47 Caton RD
  • Corning, NY 14830-3741

Phone: (607) 937-4385

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1104173822
Entity Type
Individual
Last Name
Clark
First Name
Bonnie
Middle Name
J
Credential
LPN
Provider Other Last Name
White
Provider Other First Name
Bonnie
Provider Other Middle Name
J
Provider Other Last Name Type Code
1
Mailing Street Address
47 Caton RD
Mailing City
Corning
Mailing State
NY
Mailing ZIP Code
14830-3741
Mailing Country
US
Mailing Phone
(607) 937-4385
Practice Street Address
47 Caton RD
Practice City
Corning
Practice State
NY
Practice ZIP Code
14830-3741
Practice Country
US
Practice Phone
(607) 937-4385
Enumeration Date
August 13, 2012
Last Updated
August 13, 2012
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)