TRESSA BONASSO NPI 1124611454

NPI Information

  • NPI: 1124611454
  • Provider Name: TRESSA BONASSO
  • Classification: Nurse Practitioner - 363LP0200X
  • Specialization: Pediatrics
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 23 TRESARA DR
    FAIRMONT, WV
    ZIP 26554
  • Phone: (304) 694-5898

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NPI Details

Tressa Bonasso is a pediatrics nurse practitioner in Fairmont, WV. Tressa Bonasso NPI is 1124611454. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

23 TRESARA DR
FAIRMONT, WV
ZIP 26554-837
Phone: (304) 694-5898

The NPI 1124611454 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/17/2021 and was last updated on 8/23/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0200XNurse PractitionerPediatrics106662WEST VIRGINIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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