Acosta, Bonita
Acosta, Bonita is an individual health care provider with primary practice located at 115 Sw Pine Street , Canyonville OR 97417-0198. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Acosta, Bonita can be contacted via phone (541) 839-4211.Contact Information
Primary practice address
115 Sw Pine Street
Canyonville OR 97417-0198
Phone: (541) 839-4211
Fax: (541) 839-4858
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 078040445N1 | Oregon |
Profile Details
| NPI number | 1295882512 |
|---|---|
| LBN Legal business name | Acosta, Bonita |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 5th, 2007 |
| Last updated | Dec 29th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295882512 | NPPES |
| Oregon | MEDICAID | 005269 |
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