Diane Marie Bonifas, RN

Individual provider Active NPI Registered Nurse · Delphos, OH

NPI 1891362620 · NPPES record last updated Jun 9, 2021

Key facts

NPI
1891362620
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
209362 (OH)
Practice address
10029 Bockey Rd
Delphos, OH 45833-8832
Phone
(419) 692-0063
NPI assigned
Jun 9, 2021
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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
209362OHMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 209362 OH Yes

Addresses

Primary practice location

10029 Bockey Rd
Delphos, OH 45833-8832

Mailing address

10029 Bockey Rd
Delphos, OH 45833-8832

Other identifiers

IdentifierTypeStateIssuer
209362OtherOHRN

Electronic endpoints

TypeEndpointUseAffiliation
Other URL diane.bonifas@trilogyhs.com

Other providers in Delphos, OH

All providers in Delphos, OH · Registered Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.