Kelley M Bonowski, DNP, RN, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP11360 Issued in AZ

Practice address

5310 W Thunderbird Rd Ste 301
Glendale, AZ 85306-4710

Phone

(602) 865-4442

NPI assigned

May 15, 2018

Last updated

Feb 2, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549065600000",
    "number": "1891285854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 W THUNDERBIRD RD STE 301",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064710",
            "telephone_number": "602-865-4442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 W THUNDERBIRD RD STE 301",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064710",
            "telephone_number": "602-865-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONOWSKI",
        "first_name": "KELLEY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DNP, RN, CPNP-PC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-15",
        "last_updated": "2019-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AZ",
            "license": "RN109394",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AZ",
            "license": "AP11360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Ann Bolyog, FNP-C
• Bradley Boman, DO
• Elisa Bomgaars, MD
• Seaton Bonar, DPT
• Marsha Ann Bonnell, FNP
• Adam Bonventre
• Natasha Boord, LMSW
• Chaz Callie Booth
• Amy Blanshard Boots, D.O.
• Ole Borch-Christensen, MD

• Pediatric Nurse Practitioner in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Pediatric Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2019; 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.