Titcomb, Bonni G.

Titcomb, Bonni G. is an individual health care provider with primary practice located at 1577 Roberts Dr Siote 323, Jacksonville Beach FL 32250-3264. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology, which is considered as her primary health care specialty. Titcomb, Bonni G. can be contacted via phone (904) 241-9775.

Contact Information

Primary practice address
1577 Roberts Dr Siote 323 Jacksonville Beach FL 32250-3264
Phone: (904) 241-9775
Fax: (904) 249-3638
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology 363LX0001X ARNP 624442 Florida

Profile Details

NPI number 1366484842
LBN Legal business name Titcomb, Bonni G.
Credentials A.R.N.P.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 11th, 2006
Last updated Nov 6th, 2015 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366484842 NPPES
Florida MEDICAID 308691700

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