William Bodnar, FNP-BC

Individual provider Active NPI Family Nurse Practitioner · Clarkston, GA

NPI 1033767223 · NPPES record last updated Aug 30, 2019

Key facts

NPI
1033767223
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
RN176683 (GA)
Practice address
3701 College Ave
Clarkston, GA 30021-2508
Phone
(678) 383-1383
NPI assigned
Aug 30, 2019
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RN176683GAMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN176683 GA Yes

Addresses

Primary practice location

3701 College Ave
Clarkston, GA 30021-2508

Mailing address

PO Box 8232
Atlanta, GA 31106-0232
Phone (404) 771-8365

Other providers in Clarkston, GA

All providers in Clarkston, GA · Family Nurse Practitioner in Georgia

Sources for this page

Verify at the official NPI Registry.