BONNIE RAE NPI 1619049756

NPI Information

NPI: 1619049756
Provider Name: BONNIE RAE
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
170 MORTON ST
JAMAICA PLAIN, MA
ZIP 02130
Phone: (617) 971-3961
Get Directions

Bonnie Rae is a family nurse practitioner in Jamaica Plain, MA. Bonnie Rae NPI is 1619049756. 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:

170 MORTON ST
JAMAICA PLAIN, MA
ZIP 02130-735
Phone: (617) 971-3961

The NPI 1619049756 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 11/14/2006 and was last updated on 11/8/2012.

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
1	363LF0000X	Nurse Practitioner	Family	101-0022621	VERMONT	No
2	363LF0000X	Nurse Practitioner	Family	214532	MASSACHUSETTS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	NP214532	OTHER	MASSACHUSETTS	MASSACHUSETTS APN
2	101-0022621	OTHER	VERMONT	LICENSE

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: 4/28/2024

NPI Synchronization or Removal

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