Provider Demographics
NPI:1285742494
Name:VOLL, BONNIE J (CRNA)
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:J
Last Name:VOLL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:BONNIE
Other - Middle Name:J
Other - Last Name:MANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:621 13TH AVE S
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-8019
Mailing Address - Country:US
Mailing Address - Phone:239-784-3004
Mailing Address - Fax:
Practice Address - Street 1:809 E MARION AVE
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-3819
Practice Address - Country:US
Practice Address - Phone:941-637-2580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2672642367500000X
LAAP01028367500000X
MNR094013-1367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00271266OtherRAILROAD MEDICARE
FLG3261OtherBLUE SHIELD
FLP00271266OtherRAILROAD MEDICARE