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
Fax: (541) 839-4858
Website:

Health care specialties

SpecialtyCodeLicense #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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1295882512 NPPES
Oregon MEDICAID 005269

Popular Providers