Cathy Jo Bonney
Individual provider Active NPI Nurse's Aide · Ferguson, MO
NPI 1669722559 · NPPES record last updated Sep 18, 2012
Key facts
- NPI
- 1669722559
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse's Aide 376K00000X
- Practice address
- 130 Spring Ave
Ferguson, MO 63135-2345 - Phone
- (314) 819-3071
- NPI assigned
- Sep 18, 2012
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | Yes |
Addresses
Primary practice location
130 Spring Ave
Ferguson, MO 63135-2345
Mailing address
130 Spring Ave
Ferguson, MO 63135-2345
Phone (314) 819-3071
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001834564 | Other | MO | DAY CARE |
Other providers in Ferguson, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 18, 2012. 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.