NPI 1700501830 · live from the CMS NPI Registry
Harley Bonniville, CPNP-PC
Nurse Practitioner, Pediatrics in Williamsburg, VA. National Provider Identifier 1700501830, active.
NPI record
| NPI | 1700501830 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 119 Bulifants Blvd, Williamsburg, VA 23188 |
| Practice phone | 757-564-7337 |
| Mailing address | 2513 Spring Bridge Pl, Sandston, VA 23150 |
| Enumerated | October 11, 2022 |
| Last updated | October 11, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | 0024184256 (VA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.