Myrna Mae Bonifacio, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN12825 Issued in NV

Practice address

4525 S Sandhill Rd Ste 111
Las Vegas, NV 89121-5955

Phone

(702) 353-5417

NPI assigned

Mar 26, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Myrna Mae Bonifacio Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1225533854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 S SANDHILL RD STE 111",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215955",
            "telephone_number": "702-353-5417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 S SANDHILL RD STE 111",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215955",
            "telephone_number": "702-353-5417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONIFACIO",
        "first_name": "MYRNA",
        "middle_name": "MAE",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NV",
            "license": "LPN12825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MYRNA",
            "last_name": "BONIFACIO",
            "middle_name": "MAE",
            "prefix": "MS.",
            "credential": "LPN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Janice Noelani Bonglo, RN
• Erode Bonhomme
• Shaniqua Bonhomme
• Miklos Boni Jr.
• Corey Bonifacio
• Trisha-Anne Jao-Chico Bonifacio
• Lizdary Bonilla Flores
• Amelia Elizabeth Bonilla Sorto
• Alejandro Bonilla
• Ana Gloria Bonilla

• Licensed Practical Nurse in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Licensed Practical Nurse in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.