Provider Demographics
NPI:1497034458
Name:BONIOL, JESSICA NICOLE (MSN, FNP-BC, APRN)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:NICOLE
Last Name:BONIOL
Suffix:
Gender:F
Credentials:MSN, FNP-BC, APRN
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:NICOLE
Other - Last Name:DRAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, MSN, FNP-BC
Mailing Address - Street 1:213 SPARROW HAWK
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-5849
Mailing Address - Country:US
Mailing Address - Phone:469-585-2713
Mailing Address - Fax:
Practice Address - Street 1:5148 VILLAGE CREEK DR UNIT 300
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5064
Practice Address - Country:US
Practice Address - Phone:469-661-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX724324163W00000X
TXAP120667363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse