Spade, Bonita A

Spade, Bonita A is an individual health care provider with primary practice located at 2845 Tricom St , North Charleston SC 29406-9172. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Spade, Bonita A can be contacted via phone (843) 797-1770.

Contact Information

Primary practice address
2845 Tricom St North Charleston SC 29406-9172
Phone: (843) 797-1770
Fax: (843) 553-1498
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X R64665 South Carolina

Profile Details

NPI number 1861569329
LBN Legal business name Spade, Bonita A
Credentials FNP,CDE
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 29th, 2006
Last updated Jul 9th, 2007 - about 19 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 1861569329 NPPES
South Carolina MEDICAID NP0283
South Carolina Other R64665

Popular Providers