Provider Demographics
NPI:1194141697
Name:MARTINSON, BONNIE JEAN (FNP)
Entity type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:JEAN
Last Name:MARTINSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:15655 CYPRESS WOODS MEDICAL DRIVE SUITE 110
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77014
Mailing Address - Country:US
Mailing Address - Phone:281-580-7004
Mailing Address - Fax:281-580-1872
Practice Address - Street 1:15655 CYPRESSWOOD MEDICAL DR STE 110
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014-1488
Practice Address - Country:US
Practice Address - Phone:281-580-7004
Practice Address - Fax:281-580-1872
Is Sole Proprietor?:No
Enumeration Date:2014-03-09
Last Update Date:2016-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX464708363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily