Provider Demographics
NPI:1730959453
Name:KAISER, BONNIE ANNE
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:ANNE
Last Name:KAISER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 RYAN RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45503-6661
Mailing Address - Country:US
Mailing Address - Phone:937-541-9064
Mailing Address - Fax:
Practice Address - Street 1:1213 RYAN RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45503-6661
Practice Address - Country:US
Practice Address - Phone:937-541-9064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker