National Provider Identifier

Bonita L Fredericks, LPN

Bonita L Fredericks, LPN is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Darien Center, NY and a listed phone number of (585) 547-9367.

NPI 1518139021Darien Center, NYLicensed Practical Nurse

Profile Overview

NPI
1518139021
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
March 25, 2008
Last Updated
March 25, 2008

Practice Location

  • 1177 Sumner RD
  • Darien Center, NY 14040-9797

Phone: (585) 547-9367

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1518139021
Entity Type
Individual
Last Name
Fredericks
First Name
Bonita
Middle Name
L
Name Prefix
Mrs.
Credential
LPN
Mailing Street Address
1177 Sumner RD
Mailing City
Darien Center
Mailing State
NY
Mailing ZIP Code
14040-9797
Mailing Country
US
Mailing Phone
(585) 547-9367
Practice Street Address
1177 Sumner RD
Practice City
Darien Center
Practice State
NY
Practice ZIP Code
14040-9797
Practice Country
US
Practice Phone
(585) 547-9367
Enumeration Date
March 25, 2008
Last Updated
March 25, 2008
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)
Other Identifiers
02705966 (NY)