Bonny J Holm, LPN
Individual provider Active NPI Licensed Practical Nurse · North Pole, AK
NPI 1043336183 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1043336183
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 3692 (AK)
- Practice address
- 167 S Santa Claus LN
North Pole, AK 99705-7702 - Phone
- (907) 488-8555
- Fax
- (907) 488-8556
- NPI assigned
- Mar 21, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3692 | AK | MD | Anesthesiology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 3692 | AK | Yes |
Addresses
Primary practice location
167 S Santa Claus LN
North Pole, AK 99705-7702
Mailing address
167 S Santa Claus LN
North Pole, AK 99705-7702
Phone (907) 488-8555
Other providers in North Pole, AK
- Jeremy Robert Harvill
- Stacy Harvill
- Sandra L Hembree
- Brianne Henderson
- Amy Ann Hendrickson
- Leif Joseph Holm
- Richard Clayton Holm
- Marlecia Holston
- Hunny Bunny'S Alh, LLC
- Angela Hutwagner
All providers in North Pole, AK · Licensed Practical Nurse in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.